Provider Demographics
NPI:1285643593
Name:FAMILY RESPIRATORY & MEDICAL SUPPLY CORPORATION, INC.
Entity Type:Organization
Organization Name:FAMILY RESPIRATORY & MEDICAL SUPPLY CORPORATION, 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:R
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:410-254-0821
Practice Address - Street 1:5609 DUPONT PKWY STE 15
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-9211
Practice Address - Country:US
Practice Address - Phone:302-653-3603
Practice Address - Fax:302-653-3616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000002087Medicaid
DE0201240003Medicare ID - Type UnspecifiedMEDICARE NUMBER