Maryland Success Academy LLC Dba Maryland Success Lab LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MARYLAND SUCCESS ACADEMY LLC DBA MARYLAND SUCCESS LAB LLC

Doing business as

Maryland Success Lab LLC

Practice address

9854 Liberty Rd Ste E
Randallstown, MD 21133-2058

Phone

(443) 353-9729

NPI assigned

Mar 17, 2023

Last updated

Mar 17, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer Hubbard, MED, NURSE EDUCATORNPI 1043836885

Title

President

Phone

(443) 353-9729

Specialties & licenses 1

Addresses

Other names 1

• Maryland Success Lab LLC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Hubbard

  • Registered Nurse
  • Randallstown, MD
  • NPI 1043836885
  NPD Authorized official

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679011200000",
    "number": "1205537016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9854 LIBERTY RD STE E",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211332058",
            "telephone_number": "443-353-9729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9854 LIBERTY RD STE E",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211332058",
            "telephone_number": "443-353-9729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND SUCCESS ACADEMY LLC DBA MARYLAND SUCCESS LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A",
        "authorized_official_last_name": "HUBBARD",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "443-353-9729",
        "authorized_official_credential": "MED, NURSE EDUCATOR"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maryland Success Lab LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sakina Marvi, PHARMD
• Ivory Marvin
• Maryland Healthcare Clinics
• Maryland Medical Supply LC
• Maryland Success Academy LLC (Maryland Success Lab, LLC)
• Mason Dixon Dialysis Facilities Inc (Baltimore County Dialysis Center)
• Brynne Matthews
• Ria Terrelle McCormick
• Rachel Elizabeth McDonald
• Nichelle McGirt

• Durable Medical Equipment & Medical Supplies in Randallstown, MD
• Providers in Randallstown, 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 Mar 17, 2023; 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.