Provider Demographics
NPI:1801072426
Name:FRIEL PROSTHETICS, INC.
Entity type:Organization
Organization Name:FRIEL PROSTHETICS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:P
Authorized Official - Last Name:FRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-652-9282
Mailing Address - Street 1:4845 RUGBY AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3018
Mailing Address - Country:US
Mailing Address - Phone:301-652-9282
Mailing Address - Fax:301-652-7585
Practice Address - Street 1:4845 RUGBY AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3018
Practice Address - Country:US
Practice Address - Phone:301-652-9282
Practice Address - Fax:301-652-7585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD453204000Medicaid
MD0350490001Medicare NSC