Organization
VASTLAND, LLC
Active
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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