Provider Demographics
NPI:1528402641
Name:FAMILY MEDICAL SERVICE LLC.
Entity Type:Organization
Organization Name:FAMILY MEDICAL SERVICE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DWAYNE
Authorized Official - Middle Name:CARLTON
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-277-9253
Mailing Address - Street 1:2911 LLOYD CT
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-1164
Mailing Address - Country:US
Mailing Address - Phone:202-277-9253
Mailing Address - Fax:
Practice Address - Street 1:2911 LLOYD CT
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-1164
Practice Address - Country:US
Practice Address - Phone:202-277-9253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-19
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies