# AMERICOAST MARYLAND LLC

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

## Provider details

- **NPI number:** 1154434819
- **Authorized official:** WENDY RUSSALESI (CCO)
- **Authorized official phone:** (484) 246-9499

## Contact information

- **Practice address:** 1310 INNOVATION ST STE H-L, MIDDLE RIVER, MD 21220-2179
- **Practice address phone:** (410) 202-2784
- **Practice address fax:** (410) 918-0633
- **Mailing address:** 555 E NORTH LN STE 5075, CONSHOHOCKEN, PA 19428-2490

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | — | NULL | — |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | D01734 | MD | — |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | R2267 | MD | Yes |

## Other

- **Enumeration date:** 08/16/2006
- **Last updated:** 12/12/2025