Provider Demographics
NPI:1578334421
Name:CANDOL HEALTHCARE SOLUTIONS
Entity Type:Organization
Organization Name:CANDOL HEALTHCARE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTELONGO-VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-320-3219
Mailing Address - Street 1:9519 HALLHURST RD
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4820
Mailing Address - Country:US
Mailing Address - Phone:682-320-3219
Mailing Address - Fax:
Practice Address - Street 1:9519 HALLHURST RD
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-4820
Practice Address - Country:US
Practice Address - Phone:682-320-3219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition