Provider Demographics
NPI:1891860698
Name:MD MEDICAL SUPPLIES INC.
Entity Type:Organization
Organization Name:MD MEDICAL SUPPLIES INC.
Other - Org Name:MD MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:PROF
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:KATRICE
Authorized Official - Last Name:PADGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-464-1700
Mailing Address - Street 1:3756 CLIPPER BAY DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-2944
Mailing Address - Country:US
Mailing Address - Phone:757-464-1700
Mailing Address - Fax:757-961-0824
Practice Address - Street 1:3756 CLIPPER BAY DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-2944
Practice Address - Country:US
Practice Address - Phone:757-464-1700
Practice Address - Fax:757-961-0824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4890740001Medicare NSC