Organization
MEDSPACK MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PRAMOD ARIKERI (PRESIDENT)
(301) 216-1190
Entity
Organization
Contact information
Practice address
1300 PICCARD DR, LL-16, ROCKVILLE, MD 20850-4303
(301) 216-1190
Mailing address
1300 PICCARD DR, LL-16, ROCKVILLE, MD 20850-4303
(301) 216-1190
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
R4156
MD
3336L0003X
Long Term Care Pharmacy
Primary
PW0344
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R4156
RSA DME PERMIT
MD
Enumeration date
01/24/2011
Last updated
07/26/2021
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