1154326866 NPI number — FAMILY RESPIRATORY & MEDICAL SUPPLY, INC.

Table of content: (NPI 1154326866)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154326866 NPI number — FAMILY RESPIRATORY & MEDICAL SUPPLY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY RESPIRATORY & MEDICAL SUPPLY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154326866
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/16/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5522 HARFORD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21214-2231
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-254-0202
Provider Business Mailing Address Fax Number:
410-254-3912

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5522 HARFORD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21214-2231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-254-0202
Provider Business Practice Location Address Fax Number:
410-254-3912
Provider Enumeration Date:
06/17/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SUTER
Authorized Official First Name:
KENNETH
Authorized Official Middle Name:
RICHARD
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
410-254-0202

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X , with the licence number: 019632 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 099978400 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100002087 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 270857 . This is a "ALLIANCE, MAMSI, ETAL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 52175301 . This is a "BCBS OF CUMBERLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 52958 . This is a "AMERGROUP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 056215 . This is a "NORTHWOOD NPN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: F381 . This is a "CAREFIRST BC, ETAL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 216994 . This is a "HIGHMARK" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 37262 . This is a "INJ. WORKERS INS. FUND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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