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Organization

ACCESS ABILITY ORTHOTICS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID RANDY HARRIS C.O. (OWNER)
(301) 776-5200
Entity
Organization

Contact information

Practice address
14300 CHERRY LANE CT, SUITE 213, LAUREL, MD 20707-4958
(301) 776-5200
(301) 776-4480
Mailing address
14300 CHERRY LANE CT, SUITE 213, LAUREL, MD 20707-4958
(301) 776-5200
(301) 776-4480

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CO001692
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009190937
VA
05
034984200
DC
01
100699
JOHNS HOPKINS HEALTHCARE
01
115716
AMERIGROUP
01
465167
ANTHEM BLUECROSS
05
510324000
MD
01
525679
NCPPO
01
K2930001
BLUECROSS/BLUESHIELD/NCA
01
MK79
BC/BS OF MD
Enumeration date
03/01/2006
Last updated
10/25/2016
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