Provider Demographics
NPI:1194036384
Name:SALA, LLC
Entity Type:Organization
Organization Name:SALA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALONZO
Authorized Official - Middle Name:
Authorized Official - Last Name:NIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-782-1122
Mailing Address - Street 1:11728 BROOKEVILLE LANDING CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-4504
Mailing Address - Country:US
Mailing Address - Phone:410-782-1122
Mailing Address - Fax:240-266-0573
Practice Address - Street 1:3700 N CAPITOL ST NW
Practice Address - Street 2:SHERMAN BUILDING
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-8400
Practice Address - Country:US
Practice Address - Phone:410-782-1122
Practice Address - Fax:240-266-0573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC350000073931332B00000X
MD13852399332BN1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies