Healthcare Provider Details

I. General information

NPI: 1538255575
Provider Name (Legal Business Name): ESKOTT MEDICAL SUPPLY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6475 NEW HAMPSHIRE AVE SUITE 203
HYATTSVILLE MD
20783-3269
US

IV. Provider business mailing address

6475 NEW HAMPSHIRE AVE SUITE 203
HYATTSVILLE MD
20783-3269
US

V. Phone/Fax

Practice location:
  • Phone: 301-891-1141
  • Fax: 301-891-1022
Mailing address:
  • Phone: 301-891-1141
  • Fax: 301-891-1022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number11540232
License Number StateMD

VIII. Authorized Official

Name: MR. ESEMA EKOTT UMOHANWAN
Title or Position: CEO
Credential:
Phone: 301-891-1141