Individual
CHARLOTTE M POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1031 PULASKI HWY, HAVRE DE GRACE, MD 21078-2603
(410) 939-2760
Mailing address
1031 PULASKI HWY, HAVRE DE GRACE, MD 21078-2603
(410) 939-2760
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
428952
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020787710
DURABLE GOODS SUPPLIER
MD
Enumeration date
12/03/2015
Last updated
12/03/2015
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