Provider Demographics
NPI:1497924898
Name:STATS MEDICAL SUPPLIES & EQUIPMENT
Entity Type:Organization
Organization Name:STATS MEDICAL SUPPLIES & EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLUSHOLA
Authorized Official - Middle Name:E
Authorized Official - Last Name:FASHINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-617-0066
Mailing Address - Street 1:10760 HICKORY RIDGE RD
Mailing Address - Street 2:SUITE 123
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3682
Mailing Address - Country:US
Mailing Address - Phone:301-617-0066
Mailing Address - Fax:443-542-9372
Practice Address - Street 1:10760 HICKORY RIDGE RD
Practice Address - Street 2:SUITE 123
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3682
Practice Address - Country:US
Practice Address - Phone:301-617-0066
Practice Address - Fax:443-542-9372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2412332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies