Provider Demographics
NPI:1043542822
Name:S&S MEDICAL,LLC
Entity Type:Organization
Organization Name:S&S MEDICAL,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISPENSING NURSE
Authorized Official - Prefix:
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:443-867-5329
Mailing Address - Street 1:750 STATE ROUTE 3 S
Mailing Address - Street 2:SUITE B17
Mailing Address - City:GAMBRILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21054-1300
Mailing Address - Country:US
Mailing Address - Phone:443-867-5329
Mailing Address - Fax:
Practice Address - Street 1:750 STATE ROUTE 3 S
Practice Address - Street 2:SUITE B17
Practice Address - City:GAMBRILLS
Practice Address - State:MD
Practice Address - Zip Code:21054-1300
Practice Address - Country:US
Practice Address - Phone:443-867-5329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone