Provider Demographics
NPI:1255615506
Name:DISABILITY LOGISTICS, LLC
Entity type:Organization
Organization Name:DISABILITY LOGISTICS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH (JOE)
Authorized Official - Middle Name:I
Authorized Official - Last Name:MONYE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:443-750-4967
Mailing Address - Street 1:PO BOX 11022
Mailing Address - Street 2:5708 BELLONA AVE
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-0022
Mailing Address - Country:US
Mailing Address - Phone:443-750-4967
Mailing Address - Fax:443-703-7550
Practice Address - Street 1:5708 BELLONA AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-3509
Practice Address - Country:US
Practice Address - Phone:443-750-4967
Practice Address - Fax:443-703-7550
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PSYCHIATRIC REHABILITATION SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-05
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14455777332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies