Enchanted Medical LLC

Primary specialty

Dialysis Equipment & Supplies (DME)Taxonomy code 332BD1200X

Legal business name

ENCHANTED MEDICAL LLC

Practice address

10040 Baltimore National Pike Ste E110
Ellicott City, MD 21042-3796

Phone

(410) 988-8740

Fax

(410) 988-8753

NPI assigned

Sep 24, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Emmanuel Tesfaye, PHARM.DNPI 1609178128

Title

Owner

Phone

(410) 988-8740

Specialties & licenses 1

Addresses

Other names 1

• Enchanted Medical Supplies Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Emmanuel Tesfaye, PHARM. D

  • Pharmacist
  • Lanham, MD
  • NPI 1609178128
  NPD Authorized official
• Amir Salar Sarlak, DDS

  • Dentist
  • Columbia, MD
  • NPI 1366534356
  NPD (past)

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537747200000",
    "number": "1073097150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10040 BALTIMORE NATIONAL PIKE STE E110",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423796",
            "telephone_number": "410-988-8740",
            "fax_number": "410-988-8753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10040 BALTIMORE NATIONAL PIKE STE E110",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423796",
            "telephone_number": "410-988-8740",
            "fax_number": "410-988-8753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENCHANTED MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-24",
        "last_updated": "2018-09-24",
        "status": "A",
        "authorized_official_last_name": "TESFAYE",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-988-8740",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "332BD1200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Enchanted Medical Supplies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ellicott Dental & Specialty LLC
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• Mia Ellis, LCPC
• Aiman Eltahir, DPT
• Eman Inc
• Nonso Enekwe, PHARM.D.
• William Eng Jr.
• Enhancing Movement LLC
• Jennifer Davis Enlow, D.D.S.
• Erika Lynn Nichelson LLC

• Durable Medical Equipment & Medical Supplies in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Durable Medical Equipment & Medical Supplies in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.