Maryland Medical Supply LC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MARYLAND MEDICAL SUPPLY LC

Practice address

3912 Shenton Rd
Randallstown, MD 21133-2206

Phone

(410) 944-1804

Fax

(410) 982-6432

NPI assigned

Mar 9, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Sydonne Newland

Title

Administrator

Phone

(410) 944-1804

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308528000000",
    "number": "1619009222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3912 SHENTON RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211332206",
            "telephone_number": "410-944-1804",
            "fax_number": "410-982-6432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3912 SHENTON RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211332206",
            "telephone_number": "410-944-1804",
            "fax_number": "410-982-6432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND MEDICAL SUPPLY LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2011-06-20",
        "status": "A",
        "authorized_official_last_name": "NEWLAND",
        "authorized_official_first_name": "SYDONNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "410-944-1804",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376650100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Martin
• Regina Marie Martin, PA C
• Sakina Marvi, PHARMD
• Ivory Marvin
• Maryland Healthcare Clinics
• Maryland Success Academy LLC (Maryland Success Lab, LLC)
• Maryland Success Academy LLC Dba Maryland Success Lab LLC (Maryland Success Lab LLC)
• Mason Dixon Dialysis Facilities Inc (Baltimore County Dialysis Center)
• Brynne Matthews
• Ria Terrelle McCormick

• 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 Jun 20, 2011; 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.