# MEDSPACK MD LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063717015
- **Authorized official:** MR. PRAMOD ARIKERI (PRESIDENT)
- **Authorized official phone:** (301) 216-1190

## Contact information

- **Practice address:** 1300 PICCARD DR, LL-16, ROCKVILLE, MD 20850-4303
- **Practice address phone:** (301) 216-1190
- **Mailing address:** 1300 PICCARD DR, LL-16, ROCKVILLE, MD 20850-4303
- **Mailing address phone:** (301) 216-1190

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | R4156 | MD | — |
| 3336L0003X | Long Term Care Pharmacy | PW0344 | MD | Yes |

## Other

- **Enumeration date:** 01/24/2011
- **Last updated:** 07/26/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | R4156 | RSA DME PERMIT | MD |