Healthcare Provider Details

I. General information

NPI: 1366881609
Provider Name (Legal Business Name): CAPITAL RAMP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2013
Last Update Date: 06/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6407 CATALPA RD
FORK MD
21051-9732
US

IV. Provider business mailing address

6407 CATALPA RD
FORK MD
21051-9732
US

V. Phone/Fax

Practice location:
  • Phone: 888-994-7266
  • Fax: 888-994-7267
Mailing address:
  • Phone: 888-994-7266
  • Fax: 888-994-7267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberCS029015
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: GREGORY RICHARD LAZZARONI
Title or Position: MANAGER
Credential:
Phone: 888-994-7267