Provider Demographics
NPI:1619188430
Name:TRUST MEDICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:TRUST MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:INIOBONG
Authorized Official - Middle Name:UDOH
Authorized Official - Last Name:NKANTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-793-2528
Mailing Address - Street 1:2517 E CHASE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-3747
Mailing Address - Country:US
Mailing Address - Phone:301-793-2528
Mailing Address - Fax:
Practice Address - Street 1:2517 E CHASE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-3747
Practice Address - Country:US
Practice Address - Phone:301-793-2528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD406716900Medicaid
MD4826860002Medicare ID - Type Unspecified