Provider Demographics
NPI:1417781394
Name:ARDEX HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:ARDEX HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADEOLA
Authorized Official - Middle Name:RITA
Authorized Official - Last Name:ADEOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-422-2406
Mailing Address - Street 1:7506 BLUE SUN DR
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-8788
Mailing Address - Country:US
Mailing Address - Phone:410-422-2406
Mailing Address - Fax:
Practice Address - Street 1:3450 LAUREL FORT MEADE RD STE 105
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-2040
Practice Address - Country:US
Practice Address - Phone:410-422-2406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-31
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health