Healthcare Provider Details

I. General information

NPI: 1003978958
Provider Name (Legal Business Name): HORIZON RESPIRATORY MEDICAL SUPPLY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 11/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1997 ANNAPOLIS EXCHANGE PKWY SUITE 300
ANNAPOLIS MD
21401-3271
US

IV. Provider business mailing address

PO BOX 6178
ANNAPOLIS MD
21401-0178
US

V. Phone/Fax

Practice location:
  • Phone: 410-897-0514
  • Fax: 866-757-2727
Mailing address:
  • Phone: 410-897-0514
  • Fax: 866-757-2727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberR2345
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2278H0200X
TaxonomyHome Health Certified Respiratory Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. JUMOKE AKINNAGBE
Title or Position: CHIEF OPERATING OFFICER
Credential: BS
Phone: 410-897-0514