Organization
MEDSTATS RESIDENTIAL AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYOBAMI O FASHINA (CEO/OWNER)
(202) 664-3977
Entity
Organization
Contact information
Practice address
10760 HICKORY RIDGE RD STE 123, COLUMBIA, MD 21044-3682
(202) 664-3977
(443) 542-9372
Mailing address
10760 HICKORY RIDGE RD STE 123, COLUMBIA, MD 21044-3682
(202) 664-3977
(443) 542-9372
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
05/07/2013
Last updated
02/25/2014
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