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NPI 1497413447

NPI 1497413447 : TRIPPLEMO SUPPORT SERVICES, INC : RANDALLSTOWN, MD

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General NPI Number Information
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    NPI Number           |    1497413447
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    Entity Type          |    Organization 
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    Legal Business Name  |    TRIPPLEMO SUPPORT SERVICES, INC 
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Dates
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    Enumeration Date     |    12/07/2021
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    Last Update Date     |    12/07/2021
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Provider Practice Location Address
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    Address Line         |    3724 TALL GRASS CT 
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    City                 |    RANDALLSTOWN
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    State                |    MD
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    Zip                  |    21133-2824
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    Country              |    US
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    Telephone            |    307-223-6010
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3724 TALL GRASS CT 
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    City                 |    RANDALLSTOWN
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    State                |    MD
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    Zip                  |    21133-2824
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    Country              |    US
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    Telephone            |    307-223-6010
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     OLALEKAN OLAJIDE IDOWU 
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    Credential           |    
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    Telephone            |    307-223-6010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251E00000X
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    Taxonomy Name        |    Home Health Agency
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    License Number       |    
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    License Number State |    
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