Healthcare Provider Details

I. General information

NPI: 1437337102
Provider Name (Legal Business Name): KAMCO MEDICAL STAFFING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 03/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 MERCANTILE LN SUITE 210
LARGO MD
20774
US

IV. Provider business mailing address

1400 MERCANTILE LN SUITE 210
LARGO MD
20774
US

V. Phone/Fax

Practice location:
  • Phone: 301-322-8890
  • Fax: 301-322-8895
Mailing address:
  • Phone: 301-322-8890
  • Fax: 301-322-8895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number16470800
License Number StateMD

VII. Legacy identifiers

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

# 1
Identifier414846100
Identifier TypeMEDICAID
Identifier StateMD
Identifier Issuer

VIII. Authorized Official

Name: MR. BASHAYE SHARONE WARFIELD
Title or Position: DIRECTOR
Credential:
Phone: 301-322-8890