Organization
BABY LIST HEALTH, LLC
Active
Other names
SourceMD, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL G CLARK (ASSOCIATE DIRECTOR)
(516) 360-0298
Entity
Organization
Contact information
Practice address
5 RIGGS AVE STE 3, SEVERNA PARK, MD 21146-3879
(410) 431-0144
(443) 218-2064
Mailing address
5 RIGGS AVE STE 3, SEVERNA PARK, MD 21146-3879
(410) 844-4760
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BL123
MEDICARE
MD
Enumeration date
03/20/2018
Last updated
05/07/2026
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