Provider Demographics
NPI:1407140320
Name:DELMARVA DISABILITY, LLC
Entity Type:Organization
Organization Name:DELMARVA DISABILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:VAN ZANDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-726-2875
Mailing Address - Street 1:805 STATE ST
Mailing Address - Street 2:P.O. BOX 247
Mailing Address - City:SHARPTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21861-1104
Mailing Address - Country:US
Mailing Address - Phone:410-883-3291
Mailing Address - Fax:410-883-2131
Practice Address - Street 1:801 STATE ST
Practice Address - Street 2:
Practice Address - City:SHARPTOWN
Practice Address - State:MD
Practice Address - Zip Code:21861-1104
Practice Address - Country:US
Practice Address - Phone:410-883-3291
Practice Address - Fax:410-883-2131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies