Healthcare Provider Details

I. General information

NPI: 1952516585
Provider Name (Legal Business Name): DLC DISTRIBUTORS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 MCCORMICK DR SUITE 350
LARGO MD
20774-5326
US

IV. Provider business mailing address

1801 MCCORMICK DR SUITE 350
LARGO MD
20774-5326
US

V. Phone/Fax

Practice location:
  • Phone: 301-883-3661
  • Fax: 301-772-8970
Mailing address:
  • Phone: 301-883-3661
  • Fax: 301-772-8970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number StateMD

VIII. Authorized Official

Name: MS. GWENLOU A. COLEMAN-STEVENS
Title or Position: PRESIDENT, CEO
Credential: RETIRED RN
Phone: 301-883-3661