Provider Demographics
NPI:1932960200
Name:360 DURABLE MEDICAL EQUIPMENT AND SUPPLIES LLC
Entity Type:Organization
Organization Name:360 DURABLE MEDICAL EQUIPMENT AND SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHIMERE
Authorized Official - Middle Name:
Authorized Official - Last Name:BECOTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-486-8050
Mailing Address - Street 1:2446 N CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-5113
Mailing Address - Country:US
Mailing Address - Phone:410-805-9464
Mailing Address - Fax:
Practice Address - Street 1:2446 N CHARLES ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-5113
Practice Address - Country:US
Practice Address - Phone:410-805-9464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies