Provider Demographics
NPI:1568407914
Name:ALD ENTERPRISES, LLC
Entity Type:Organization
Organization Name:ALD ENTERPRISES, LLC
Other - Org Name:ALD INFUSION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WUTOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-536-9944
Mailing Address - Street 1:1520 CATON CENTER DR
Mailing Address - Street 2:SUITE S
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-1554
Mailing Address - Country:US
Mailing Address - Phone:410-536-9944
Mailing Address - Fax:410-536-4533
Practice Address - Street 1:1520 CATON CENTER DR
Practice Address - Street 2:SUITE S
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21227-1554
Practice Address - Country:US
Practice Address - Phone:410-536-9944
Practice Address - Fax:410-536-4533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR12013336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1256370001Medicare ID - Type Unspecified