# WESTERN MARYLAND MEDICAL SUPPLY

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

## Provider details

- **NPI number:** 1306863360
- **Authorized official:** MR. THOMAS T CHAN (CFO)
- **Authorized official phone:** (301) 790-8102

## Contact information

- **Practice address:** 12101 WINCHESTER RD, SUITE 1A, LAVALE, MD 21502-7688
- **Practice address phone:** (301) 729-4280
- **Practice address fax:** (301) 729-2944
- **Mailing address:** 12101 WINCHESTER RD, SUITE 1A, LAVALE, MD 21502-7688
- **Mailing address phone:** (301) 729-4280
- **Mailing address fax:** (301) 729-2944

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | R1119 | MD | Yes |

## Other

- **Enumeration date:** 07/16/2006
- **Last updated:** 03/19/2015