Provider Demographics
NPI:1952516585
Name:DLC DISTRIBUTORS, LLC
Entity Type:Organization
Organization Name:DLC DISTRIBUTORS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:GWENLOU
Authorized Official - Middle Name:A
Authorized Official - Last Name:COLEMAN-STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:RETIRED RN
Authorized Official - Phone:301-883-3661
Mailing Address - Street 1:1801 MCCORMICK DR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5326
Mailing Address - Country:US
Mailing Address - Phone:301-883-3661
Mailing Address - Fax:301-772-8970
Practice Address - Street 1:1801 MCCORMICK DR
Practice Address - Street 2:SUITE 350
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5326
Practice Address - Country:US
Practice Address - Phone:301-883-3661
Practice Address - Fax:301-772-8970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD332B00000X, 332BN1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies