Provider Demographics
NPI:1982976577
Name:ASTHMA MANAGEMENT GROUP RESOURCES
Entity Type:Organization
Organization Name:ASTHMA MANAGEMENT GROUP RESOURCES
Other - Org Name:ASTHMA 24
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WALEED
Authorized Official - Middle Name:ADNAN
Authorized Official - Last Name:BEIDAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-620-9222
Mailing Address - Street 1:7215 CORPORATE CT
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-8386
Mailing Address - Country:US
Mailing Address - Phone:301-620-9222
Mailing Address - Fax:301-620-9266
Practice Address - Street 1:7215 CORPORATE CT
Practice Address - Street 2:SUITE 2A
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-8386
Practice Address - Country:US
Practice Address - Phone:301-620-9222
Practice Address - Fax:301-620-9266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0445476332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
06-19-12OtherACHC
MD10445476OtherTRADER'S LICENSE