Provider Demographics
NPI:1811920820
Name:B.W.MEDICAL SUPPLY CO.,INC.
Entity type:Organization
Organization Name:B.W.MEDICAL SUPPLY CO.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FELDBLYUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-365-4408
Mailing Address - Street 1:6860 REISTERSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-1428
Mailing Address - Country:US
Mailing Address - Phone:410-602-7766
Mailing Address - Fax:
Practice Address - Street 1:6860 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-1428
Practice Address - Country:US
Practice Address - Phone:410-602-7766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2278332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC026668800Medicaid
MD184840200Medicaid
VA9113509Medicaid
MD184840200Medicaid