Provider Demographics
NPI:1427786359
Name:MERRY STARS INC.
Entity type:Organization
Organization Name:MERRY STARS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AYOMIKUN
Authorized Official - Middle Name:
Authorized Official - Last Name:FABUNMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-879-7479
Mailing Address - Street 1:3524 CARRIAGE HILL CIR APT 203
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-2961
Mailing Address - Country:US
Mailing Address - Phone:240-879-7479
Mailing Address - Fax:
Practice Address - Street 1:3524 CARRIAGE HILL CIR APT 203
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-2961
Practice Address - Country:US
Practice Address - Phone:240-879-7479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care