Healthcare Provider Details

I. General information

NPI: 1962432666
Provider Name (Legal Business Name): DISTRICT HEALTHCARE & JANITORIAL SUPPLIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10104 SENATE DR STE 201
LANHAM MD
20706-4393
US

IV. Provider business mailing address

10104 SENATE DR STE 201
LANHAM MD
20706-4393
US

V. Phone/Fax

Practice location:
  • Phone: 301-918-0200
  • Fax: 301-918-8230
Mailing address:
  • Phone: 301-918-0200
  • Fax: 301-918-8230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number16226054
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. PERNELL JEROME WILLIAMS
Title or Position: PRESIDENT
Credential:
Phone: 301-333-1750