1942329990 NPI number — TWENTY FOUR HOUR DEPENDABLE MEDICAL SUPPLIES, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942329990 NPI number — TWENTY FOUR HOUR DEPENDABLE MEDICAL SUPPLIES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TWENTY FOUR HOUR DEPENDABLE MEDICAL SUPPLIES, LLC
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:
6
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:
1942329990
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4690 MILLENNIUM DR STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELCAMP
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21017-1527
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-344-1414
Provider Business Mailing Address Fax Number:
410-344-1344

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4690 MILLENNIUM DR STE 207
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELCAMP
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21017-1525
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-344-1414
Provider Business Practice Location Address Fax Number:
410-344-1344
Provider Enumeration Date:
03/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HENDERSON
Authorized Official First Name:
CHERYLETTE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
410-344-1414

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  R2571 , 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: 012839200 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2140066 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 022947200 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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