MEDICARE: MD MEDICAL SUPPLIES INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1891860698
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MD MEDICAL SUPPLIES INC.

Provider Business Mailing Address
First Line	:	3756 CLIPPER BAY DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-2944
Country	:	US
Telephone Number	:	757-464-1700
Fax Number	:	757-961-0824

Provider Business Practice Location Address
First Line	:	3756 CLIPPER BAY DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-2944
Country	:	US
Telephone Number	:	757-464-1700
Fax Number	:	757-961-0824

Authorized Official
Title or Position	:	OWNER
Name	:	PROF. MELANIE KATRICE PADGETT
Credential	:
Telephone Number	:	757-464-1700

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	08/22/2020

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