Provider Demographics
NPI:1083441992
Name:ROBERTS SUPPORT SERVICES
Entity type:Organization
Organization Name:ROBERTS SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:AYODELE
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-848-1013
Mailing Address - Street 1:6851 OAK HALL LN STE 120
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5815
Mailing Address - Country:US
Mailing Address - Phone:240-848-1013
Mailing Address - Fax:
Practice Address - Street 1:6851 OAK HALL LN STE 120
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5815
Practice Address - Country:US
Practice Address - Phone:240-848-1013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies