Organization
GRANDIFF MEDICAL SUPPLIES INC
Active
Other names
GRANDIFF MEDICAL SUPPLIES
Organization subpart
No
Provider details
NPI number
Authorized official
IMAOBONG NNSEWO AKPAETE (DIRECTOR)
(301) 388-0596
Entity
Organization
Contact information
Practice address
20 VITAL WAY, SILVER SPRING, MD 20904-3446
(301) 388-0596
(301) 388-0597
Mailing address
20 VITAL WAY, SILVER SPRING, MD 20904-3446
(301) 388-0596
(301) 388-0597
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
R2253
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009119175
—
VA
05
—
027061500
—
DC
01
—
10079260
AMERIGROUP
MD
05
—
414364700
—
MD
Enumeration date
05/26/2006
Last updated
09/16/2008
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