Healthcare Provider Details

I. General information

NPI: 1346892742
Provider Name (Legal Business Name): BEULAH NURSING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2019
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 MERCANTILE LN STE 421
UPPER MARLBORO MD
20774-4321
US

IV. Provider business mailing address

10006 GOLD COAST CT
UPPER MARLBORO MD
20774-6087
US

V. Phone/Fax

Practice location:
  • Phone: 301-395-7874
  • Fax:
Mailing address:
  • Phone: 301-395-7874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: ADEBISI SHOWUNMI
Title or Position: ADMINISTRATOR
Credential:
Phone: 240-395-7874