Healthcare Provider Details

I. General information

NPI: 1861990947
Provider Name (Legal Business Name): VESPER MEDICAL TRANSPORT OF MARYLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2018
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 LEONARDTOWN RD STE 7
WALDORF MD
20601-3694
US

IV. Provider business mailing address

PO BOX 530747
ATLANTA GA
30353-0747
US

V. Phone/Fax

Practice location:
  • Phone: 330-495-8888
  • Fax: 330-294-1634
Mailing address:
  • Phone: 330-495-8888
  • Fax: 330-304-6329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: SARAH ANN SUSALLA
Title or Position: COO
Credential:
Phone: 330-495-8888