Individual ProviderOluwatobi OmoboNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address9831 Greenbelt Rd Ste 103, Lanham, MD 20706-6224(301) 792-0855PECOS EnrollmentBased on the most recent information from CMS, provider Oluwatobi Omobo is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1356017198Provider TypeIndividualFull NameOmobo, OluwatobiCredentialNPGenderFemaleSole ProprietorYesEnumeration Date8/20/2021Last Updated8/20/2021Contact InformationPractice LocationPractice Address9831 Greenbelt Rd Ste 103, Lanham, MD 20706-6224Phone(301) 792-0855FaxUnlisted FaxMailing LocationMailing Address9831 Greenbelt Rd Ste 103, Lanham, MD 20706-6224Phone(301) 792-0855FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LP0808XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseR228974Maryland