Provider Demographics
NPI:1043716087
Name:FAMILY MEDICAL EQUIPMENT SUPPLIES INC
Entity type:Organization
Organization Name:FAMILY MEDICAL EQUIPMENT SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NWACHUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-877-3259
Mailing Address - Street 1:2112 BEL AIR RD STE 4B
Mailing Address - Street 2:
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047-2786
Mailing Address - Country:US
Mailing Address - Phone:410-877-3259
Mailing Address - Fax:410-877-3274
Practice Address - Street 1:2112 BEL AIR RD STE 4B
Practice Address - Street 2:
Practice Address - City:FALLSTON
Practice Address - State:MD
Practice Address - Zip Code:21047-2786
Practice Address - Country:US
Practice Address - Phone:410-877-3259
Practice Address - Fax:410-877-3274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-30
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3665332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR3665OtherRSA