Onic Medical Supply, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

R2672R Issued in MD

Legal business name

ONIC MEDICAL SUPPLY, LLC

Practice address

9811 Mallard Drive,
Suite 117
Laurel, MD 20708

Phone

(240) 391-6509

Fax

(240) 391-6515

NPI assigned

Jan 5, 2009

Last updated

Jul 24, 2013By 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

Mr. Henry C. Ejemole

Title

Ops Manager

Phone

(240) 391-6509

Specialties & licenses 1

Addresses

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

Locations

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

{
    "created_epoch": "1231113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374624000000",
    "number": "1902042468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9811 MALLARD DRIVE,",
            "address_2": "SUITE 117",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20708",
            "telephone_number": "240-391-6509",
            "fax_number": "240-391-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9811 MALLARD DRIVE,",
            "address_2": "SUITE 117",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20708",
            "telephone_number": "240-391-6509",
            "fax_number": "240-391-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONIC MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-05",
        "last_updated": "2013-07-24",
        "status": "A",
        "authorized_official_last_name": "EJEMOLE",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OPS MANAGER",
        "authorized_official_telephone_number": "240-391-6509",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MD",
            "license": "R2672R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oluwamodupe Onanuga, HHA
• Iria A Ondo Bengone, DDS
• Desiree S Ong, M.D.
• Funmilayo Oni, CRNP
• Onic Medical Services, LLC
• Sussan Ononaku, FNP
• Goldmay Ogbenyalu Onuma, PMHNP
• Philomena Onwuegbule, CRNP FAMILY
• Chinyelu Onwumbiko, PHARMD
• Francisca Onyegbula

• Durable Medical Equipment & Medical Supplies in Laurel, MD
• Providers in Laurel, 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 Jul 24, 2013; 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.