Provider Demographics
NPI:1326163437
Name:MAXIMUM CHOICE MEDICAL SUPPLY,LLC
Entity Type:Organization
Organization Name:MAXIMUM CHOICE MEDICAL SUPPLY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYUDMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALTSEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-517-1917
Mailing Address - Street 1:21 MAIN ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-1294
Mailing Address - Country:US
Mailing Address - Phone:410-517-1917
Mailing Address - Fax:
Practice Address - Street 1:21 MAIN ST
Practice Address - Street 2:SUITE E
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-1294
Practice Address - Country:US
Practice Address - Phone:410-517-1917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2534332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD012930500Medicaid
MD6019760001Medicare NSC