Provider Demographics
NPI:1588860191
Name:NORBROOK MEDICAL EQUIPMENT AND SUPPLIES INC.
Entity Type:Organization
Organization Name:NORBROOK MEDICAL EQUIPMENT AND SUPPLIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANALEE
Authorized Official - Middle Name:HAVERITA AUDRY
Authorized Official - Last Name:ROBB
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:301-577-5846
Mailing Address - Street 1:9463 ANNAPOLIS RD
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3020
Mailing Address - Country:US
Mailing Address - Phone:301-577-5846
Mailing Address - Fax:301-577-1811
Practice Address - Street 1:9463 ANNAPOLIS RD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3020
Practice Address - Country:US
Practice Address - Phone:301-577-5846
Practice Address - Fax:301-577-1811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2550332B00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC057060700Medicaid
VA1588860191Medicaid
MD413385400Medicaid
DC057060700Medicaid