Provider Demographics
NPI:1265249098
Name:PRISTINE MEDICAL EQUIPMENT AND ACCESSORIES INC
Entity type:Organization
Organization Name:PRISTINE MEDICAL EQUIPMENT AND ACCESSORIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-720-9002
Mailing Address - Street 1:10176 BALTIMORE NATIONAL PIKE STE 206
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-3652
Mailing Address - Country:US
Mailing Address - Phone:410-720-9002
Mailing Address - Fax:
Practice Address - Street 1:10176 BALTIMORE NATIONAL PIKE STE 206
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-3652
Practice Address - Country:US
Practice Address - Phone:410-720-9002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies