Organization
PROVIDENCE PT & DME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GUILLAUME SERY KABERT (CEO, PRESIDENT)
(301) 277-4337
Entity
Organization
Contact information
Practice address
5810 RIVERDALE RD, RIVERDALE, MD 20737-2142
(301) 277-4337
(301) 277-4335
Mailing address
5810 RIVERDALE RD, RIVERDALE, MD 20737-2142
(301) 277-4337
(301) 277-4335
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
R2484
MD
Other
Enumeration date
08/07/2007
Last updated
08/07/2007
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