Pauline Annett Mitchell-Ejimakor

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

R2683 Issued in MD

Practice address

1300 Mercantile LN
Suite 138 E
Largo, MD 20774-5327

Phone

(240) 667-1594

Fax

(240) 667-1596

NPI assigned

Sep 29, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Pauline Annett Wilson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pauline Annett Mitchell-Ejimakor

  • Durable Medical Equipment & Medical Supplies
  • Largo, MD
  • NPI 1629375902
  NPD (past) Authorized official

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296518400000",
    "number": "1861642613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MERCANTILE LN",
            "address_2": "SUITE 138E",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745327",
            "telephone_number": "240-667-1594",
            "fax_number": "240-667-1596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MERCANTILE LN",
            "address_2": "SUITE 138 E",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745327",
            "telephone_number": "240-667-1594",
            "fax_number": "240-667-1596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL-EJIMAKOR",
        "first_name": "PAULINE",
        "middle_name": "ANNETT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-29",
        "last_updated": "2011-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MD",
            "license": "R2683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAULINE",
            "last_name": "WILSON",
            "middle_name": "ANNETT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Modern Human Solutions LLC
• Tesfaye Solomon Moges, MD

• Durable Medical Equipment & Medical Supplies in Largo, MD
• Providers in Largo, 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 Feb 1, 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.