Provider Demographics
NPI:1154326866
Name:FAMILY RESPIRATORY & MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:FAMILY RESPIRATORY & MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:SUTER
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:410-254-0202
Mailing Address - Street 1:5522 HARFORD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-2231
Mailing Address - Country:US
Mailing Address - Phone:410-254-0202
Mailing Address - Fax:410-254-3912
Practice Address - Street 1:5522 HARFORD RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-2231
Practice Address - Country:US
Practice Address - Phone:410-254-0202
Practice Address - Fax:410-254-3912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-17
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
MD019632332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD099978400Medicaid
DE100002087Medicaid
MD270857OtherALLIANCE, MAMSI, ETAL
MD52175301OtherBCBS OF CUMBERLAND
MD52958OtherAMERGROUP
MD056215OtherNORTHWOOD NPN
MDF381OtherCAREFIRST BC, ETAL
MD216994OtherHIGHMARK
MD37262OtherINJ. WORKERS INS. FUND
MD52958OtherAMERGROUP
MD056215OtherNORTHWOOD NPN
MD37262OtherINJ. WORKERS INS. FUND