Provider Demographics
NPI:1134512221
Name:KASSMEL INC
Entity Type:Organization
Organization Name:KASSMEL INC
Other - Org Name:CHERYL'S HEALTH BOUTIQUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KASSMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-653-1434
Mailing Address - Street 1:1777 REISTERSTOWN RD
Mailing Address - Street 2:STE 14A
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-1306
Mailing Address - Country:US
Mailing Address - Phone:410-653-1434
Mailing Address - Fax:410-486-7300
Practice Address - Street 1:15200 SHADY GROVE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3218
Practice Address - Country:US
Practice Address - Phone:301-330-1084
Practice Address - Fax:301-330-4167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies