Provider Demographics
NPI:1811372642
Name:MEDI-RENTS & SALES, INC.
Entity Type:Organization
Organization Name:MEDI-RENTS & SALES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:PETR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-327-7252
Mailing Address - Street 1:743 S CONKLING ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-4302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2860 OGLETOWN RD
Practice Address - Street 2:BUILDING 3 SUITE 3
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-1857
Practice Address - Country:US
Practice Address - Phone:302-525-6137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDI-RENTS & SALES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR518332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1861480048Medicaid
DE1861480048Medicaid