Provider Demographics
NPI:1316037526
Name:RITEWAY MEDICAL EQUIPMENT SUPPLIES
Entity Type:Organization
Organization Name:RITEWAY MEDICAL EQUIPMENT SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:UDOFIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-723-8400
Mailing Address - Street 1:3019 GEORGIA AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3807
Mailing Address - Country:US
Mailing Address - Phone:202-723-8400
Mailing Address - Fax:202-829-3350
Practice Address - Street 1:3019 GEORGIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3807
Practice Address - Country:US
Practice Address - Phone:202-723-8400
Practice Address - Fax:202-829-3350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC288065OtherAMERIGROUP
DC034904800Medicaid
4779910001Medicare NSC