Colleen Marie Jackson, COF

Individual provider Active NPI Durable Medical Equipment & Medical Supplies · Taneytown, MD

NPI 1346354073 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1346354073
Entity type
Individual (NPI type 1)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
License
P03001 (MD)
Practice address
417 E Baltimore St
Unit a
Taneytown, MD 21787-2300
Phone
(410) 756-5240
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X P03001 MD Yes

Addresses

Primary practice location

417 E Baltimore St
Unit a
Taneytown, MD 21787-2300

Mailing address

417 E Baltimore St
Unit a
Taneytown, MD 21787-2300
Phone (410) 756-5240

Other identifiers

IdentifierTypeStateIssuer
C22398OtherMDBOC CERFIFIED ORTH FIT
053828OtherMDJOBST FITTER NUMBER
CFO02658OtherMDABC CERTIFIED FITTER-ORTH

Other providers in Taneytown, MD

All providers in Taneytown, MD · Durable Medical Equipment & Medical Supplies in Maryland

Sources for this page

Verify at the official NPI Registry.