Provider Demographics
NPI:1629195946
Name:MACH SERVICES
Entity Type:Organization
Organization Name:MACH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARGARET-ANN
Authorized Official - Middle Name:CORETTA
Authorized Official - Last Name:HALSTEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-535-0810
Mailing Address - Street 1:5931 GENTLE CALL
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1233
Mailing Address - Country:US
Mailing Address - Phone:443-535-0810
Mailing Address - Fax:443-535-0968
Practice Address - Street 1:5931 GENTLE CALL
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1233
Practice Address - Country:US
Practice Address - Phone:410-235-0699
Practice Address - Fax:443-535-0968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5442402MG82OtherCAREFIRST BCBS PROVIDER #
MD513900700Medicaid
MD5442402MG82OtherCAREFIRST BCBS PROVIDER #