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Organization
AMERICOAST MARYLAND LLC
Active
Organization
AMERICOAST MARYLAND LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY RUSSALESI (CCO)
(484) 246-9499
Entity
Organization
Contact information
Practice address
1310 INNOVATION ST STE H-L, MIDDLE RIVER, MD 21220-2179
(410) 202-2784
(410) 918-0633
Mailing address
555 E NORTH LN STE 5075, CONSHOHOCKEN, PA 19428-2490
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
NULL
332BX2000X
Oxygen Equipment & Supplies (DME)
D01734
MD
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
R2267
MD
Other
Enumeration date
08/16/2006
Last updated
12/12/2025
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