Provider Demographics
NPI:1659791465
Name:HIGHLAND MEDICAL LLC
Entity Type:Organization
Organization Name:HIGHLAND MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:J
Authorized Official - Last Name:MAXON MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-614-7783
Mailing Address - Street 1:2711 CENTERVILLE RD STE 300
Mailing Address - Street 2:PMB 473
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1660
Mailing Address - Country:US
Mailing Address - Phone:844-614-7783
Mailing Address - Fax:
Practice Address - Street 1:2711 CENTERVILLE RD STE 400
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-1645
Practice Address - Country:US
Practice Address - Phone:844-614-7783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-18
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies