Provider Demographics
NPI:1215025903
Name:BALTIMORE MEDICAL EQUIP & SUPPLY
Entity Type:Organization
Organization Name:BALTIMORE MEDICAL EQUIP & SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BONEVENTURE
Authorized Official - Middle Name:
Authorized Official - Last Name:NWOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-919-8700
Mailing Address - Street 1:3506 HARFORD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-3121
Mailing Address - Country:US
Mailing Address - Phone:443-919-8700
Mailing Address - Fax:443-919-8701
Practice Address - Street 1:3506 HARFORD RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-3121
Practice Address - Country:US
Practice Address - Phone:443-919-8700
Practice Address - Fax:443-919-8701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4669180001Medicare NSC