Organization
MARYLAND MEDICAL SUPPLY LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SYDONNE NEWLAND (ADMINISTRATOR)
(410) 944-1804
Entity
Organization
Contact information
Practice address
3912 SHENTON RD, RANDALLSTOWN, MD 21133-2206
(410) 944-1804
(410) 982-6432
Mailing address
3912 SHENTON RD, RANDALLSTOWN, MD 21133-2206
(410) 944-1804
(410) 982-6432
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376650100
—
MD
Enumeration date
03/09/2007
Last updated
06/20/2011
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