Provider Demographics
NPI:1295818110
Name:UNIQUE MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:UNIQUE MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEAL
Authorized Official - Middle Name:A
Authorized Official - Last Name:AJAYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-496-6933
Mailing Address - Street 1:5310 OLD COURT RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-5243
Mailing Address - Country:US
Mailing Address - Phone:410-496-6933
Mailing Address - Fax:410-496-6933
Practice Address - Street 1:5310 OLD COURT RD
Practice Address - Street 2:SUITE 102
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-5243
Practice Address - Country:US
Practice Address - Phone:410-496-6933
Practice Address - Fax:410-496-6933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2257332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5243290001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER