Organization
HEALTHCAREBAHN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CONSTANTINE TITA ASANGONG (BUSINESS MANAGER)
(443) 847-6810
Entity
Organization
Contact information
Practice address
11106 SNOWDEN POND RD, LAUREL, MD 20708-3055
(443) 847-6810
Mailing address
11106 SNOWDEN POND RD, LAUREL, MD 20708-3055
(443) 847-6810
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
5000000000039429
MD
Other
Enumeration date
07/29/2013
Last updated
07/29/2013
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