Healthcare Provider Details

I. General information

NPI: 1942581137
Provider Name (Legal Business Name): HEALTH CARE DEPOT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2011
Last Update Date: 09/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14440 CHERRY LANE CT SUITE 115
LAUREL MD
20707-4946
US

IV. Provider business mailing address

14440 CHERRY LANE CT SUITE 115
LAUREL MD
20707-4946
US

V. Phone/Fax

Practice location:
  • Phone: 301-238-5191
  • Fax:
Mailing address:
  • Phone: 301-238-5191
  • Fax:

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 Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: NEELAM D ATIT
Title or Position: ADMINISTRATOR
Credential:
Phone: 301-238-5191