Provider Demographics
NPI:1093267155
Name:FRIEL PROSTHETICS INC., DBA
Entity Type:Organization
Organization Name:FRIEL PROSTHETICS INC., DBA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OCULARIST
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:P
Authorized Official - Last Name:FRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-652-9282
Mailing Address - Street 1:600 N WOLFE ST
Mailing Address - Street 2:MAUMENEE 505
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0005
Mailing Address - Country:US
Mailing Address - Phone:410-955-1113
Mailing Address - Fax:301-652-7585
Practice Address - Street 1:4845 RUGBY AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3018
Practice Address - Country:US
Practice Address - Phone:301-652-9282
Practice Address - Fax:301-652-7585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD453204000Medicaid
MD453204000Medicaid