1316173529 NPI number — FAMILY RESPIRATORY & MEDICAL SUPPLY INC

Table of content: (NPI 1316173529)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316173529 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:
1316173529
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:
410-254-0202

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
337 HOSPITAL DR
Provider Second Line Business Practice Location Address:
UNIT T
Provider Business Practice Location Address City Name:
GLEN BURNIE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21061-5547
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-787-0220
Provider Business Practice Location Address Fax Number:
410-787-8671
Provider Enumeration Date:
06/02/2009

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: 332BX2000X , with the licence number:  R1090 , 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)





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