Provider Demographics
NPI:1083976823
Name:SAPPHIRE MEDICAL LLC
Entity Type:Organization
Organization Name:SAPPHIRE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:UGO
Authorized Official - Middle Name:C
Authorized Official - Last Name:NWOKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-708-2797
Mailing Address - Street 1:401 E PRATT ST
Mailing Address - Street 2:SUITE 2414
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-3117
Mailing Address - Country:US
Mailing Address - Phone:443-708-2797
Mailing Address - Fax:443-708-2165
Practice Address - Street 1:401 E PRATT ST
Practice Address - Street 2:SUITE 2414
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-3117
Practice Address - Country:US
Practice Address - Phone:443-708-2797
Practice Address - Fax:443-708-2165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-07
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3287332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies