Organization
DME & SUPPLIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE WALLACE (PRESIDENT)
(301) 985-2985
Entity
Organization
Contact information
Practice address
9701 APOLLO DR STE 105, LARGO, MD 20774-4785
(301) 985-2985
(240) 565-6034
Mailing address
9701 APOLLO DR STE 105, LARGO, MD 20774-4785
(301) 985-2985
(240) 565-6034
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
16166763
MD
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05005571
AMERIGROUP
DC
01
—
05005571
AMERIGROUP
MD
05
—
060653859
—
DC
01
—
10085097
MEDSTAR FAMILY CHOICE OF DC
DC
01
—
10085097
MEDSTAR FAMILY CHOICE OF MD
MD
05
—
2021218766
—
VA
05
—
250694969
—
DE
05
—
444313600
—
MD
01
—
5906592
CIGNA
—
01
—
60402094
AMERI HEALTH CARITAS DC
DC
01
—
DG60
CAREFIRST CHPDC
DC
01
—
DG60
CAREFIRST BLUECHOICE
MD
05
—
DM1697
—
SC
01
—
MDPRV00024017
AETNA BETTER HEALTH
MD
01
—
PDXGR13328727
AETNA BETTER HEALTH OF MD
MD
Enumeration date
03/22/2017
Last updated
03/31/2025
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