Provider Demographics
NPI:1942487491
Name:PRINCE GEORGES MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:PRINCE GEORGES MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-613-8491
Mailing Address - Street 1:5800 ANNAPOLIS RD
Mailing Address - Street 2:SUITE 414
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-2005
Mailing Address - Country:US
Mailing Address - Phone:301-850-1040
Mailing Address - Fax:301-850-1041
Practice Address - Street 1:5800 ANNAPOLIS RD
Practice Address - Street 2:SUITE 414
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-2005
Practice Address - Country:US
Practice Address - Phone:301-850-1040
Practice Address - Fax:301-850-1041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies