Organization
VASTLAND, LLC
Active
Other names
Vastland Health Services, Vastland Nursing and Therapy Services
Organization subpart
No
Provider details
NPI number
Authorized official
WELLINGTON OGUDE (ADMINISTRATOR)
(202) 460-0403
Entity
Organization
Contact information
Practice address
6106 EDMONDSON AVE STE 102, CATONSVILLE, MD 21228-1885
(301) 978-6321
(301) 965-8625
Mailing address
6106 EDMONDSON AVE STE 102, CATONSVILLE, MD 21228-1885
(301) 978-6321
(301) 965-8625
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
R4108
MD
253Z00000X
In Home Supportive Care Agency
R4101
MD
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
R4108
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCSA800019
HCSA
MD
01
—
R4101
RSA
MD
01
—
R4108
RSA
MD
Enumeration date
08/09/2017
Last updated
08/22/2022
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