Organization
PREMIUM MEDICAL SUPPLIES & SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHI ONWUMBIKO PHARM.D (ADMINISTRATOR)
(301) 497-7222
Entity
Organization
Contact information
Practice address
316 TALBOTT AVE, LAUREL, MD 20707-4334
(301) 497-7222
(301) 497-7225
Mailing address
316 TALBOTT AVE, LAUREL, MD 20707-4334
(301) 497-7222
(301) 497-7225
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
R2541
MD
Other
Enumeration date
04/23/2007
Last updated
08/22/2020
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