NPIMap

Organization Active NPI

Dis Medical Supply

  • Durable Medical Equipment & Medical Supplies
  • Laurel, MD
National Provider Identifier
1063476117
Registry record updated Jul 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
DIS MEDICAL SUPPLY
Practice address
8730 Cherry LN
Suite a-2
Laurel, MD 20707-6212
Phone
(301) 317-3664
Fax
(301) 317-5099
NPI assigned
Apr 14, 2006
Last updated
Jul 7, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Charles Umoh
Title
Managing Employee
Phone
(301) 317-3664

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

8730 Cherry LN
Suite a-2
Laurel, MD 20707-6212

Mailing address

8730 Cherry LN
Suite a-2
Laurel, MD 20707-6212
Phone (301) 317-3664

Other identifiers 2

IdentifierTypeStateIssuer
0008869MedicaidMD
430495185AMedicaidGA

National Provider Directory

National Provider Directory

Locations

8730 Cherry Ln
Ste A2
Laurel, MD 20707
Phone (301) 317-3664

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246924800000",
    "number": "1063476117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8730 CHERRY LN",
            "address_2": "SUITE A-2",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207076212",
            "telephone_number": "301-317-3664",
            "fax_number": "301-317-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8730 CHERRY LN",
            "address_2": "SUITE A-2",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207076212",
            "telephone_number": "301-317-3664",
            "fax_number": "301-317-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIS MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-14",
        "last_updated": "2009-07-07",
        "status": "A",
        "authorized_official_last_name": "UMOH",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "MANAGING EMPLOYEE",
        "authorized_official_telephone_number": "301-317-3664",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008869",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "430495185A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.