Healthcare Provider Details

I. General information

NPI: 1164446506
Provider Name (Legal Business Name): RUXTON SUPPLY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 08/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10420 LITTLE PATUXENT PKWY SUITE 210
COLUMBIA MD
21044-3533
US

IV. Provider business mailing address

10420 LITTLE PATUXENT PKWY SUITE 210
COLUMBIA MD
21044-3533
US

V. Phone/Fax

Practice location:
  • Phone: 410-884-6844
  • Fax: 410-715-8786
Mailing address:
  • Phone: 410-884-6844
  • Fax: 410-715-8786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. EAMONN DENNIS REILLY
Title or Position: MANAGING MEMBER
Credential:
Phone: 410-715-8900