Healthcare Provider Details

I. General information

NPI: 1447170634
Provider Name (Legal Business Name): LIVING WELL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2406 STEEPLEVIEW CT
FREDERICK MD
21702-2748
US

IV. Provider business mailing address

2406 STEEPLEVIEW CT
FREDERICK MD
21702-2748
US

V. Phone/Fax

Practice location:
  • Phone: 301-359-1002
  • Fax: 301-658-2405
Mailing address:
  • Phone: 301-359-1002
  • Fax: 301-658-2405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JODI DEPASQUALE
Title or Position: OWNER
Credential: OTR/L, CAPS
Phone: 301-359-1002