Provider Demographics
NPI:1881209757
Name:BEARPAC MEDICAL LLC
Entity Type:Organization
Organization Name:BEARPAC MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRENDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ABELLA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-245-8111
Mailing Address - Street 1:4560 CRAIN HWY STE 7
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-3084
Mailing Address - Country:US
Mailing Address - Phone:301-539-3841
Mailing Address - Fax:301-971-9521
Practice Address - Street 1:124 W POINT RD
Practice Address - Street 2:
Practice Address - City:MOULTONBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03254-2548
Practice Address - Country:US
Practice Address - Phone:603-682-5710
Practice Address - Fax:603-682-5710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies