MEDICARE: ACCOLADE HEALTH CARE SERVICES L.L.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	R2821	MD
2	335E00000X	Prosthetic/Orthotic Supplier	R2821	MD
3	332B00000X	Durable Medical Equipment & Medical Supplies	R2821	MD

General Provider Information

NPI Number	:	1841528890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCOLADE HEALTH CARE SERVICES L.L.C

Provider Business Mailing Address
First Line	:	9420 ANNAPOLIS RD
Second Line	:	# 201
City	:	LANHAM
State	:	MD
Zip	:	20706-3021
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9420 ANNAPOLIS RD
Second Line	:	# 201
City	:	LANHAM
State	:	MD
Zip	:	20706-3021
Country	:	US
Telephone Number	:	301-455-7064
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. DAGMAR NGIOWA
Credential	:
Telephone Number	:	301-455-7064

Provider Enumeration Date	:	12/03/2009
Last Update Date	:	12/03/2009

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