Healthcare Provider Details

I. General information

NPI: 1326858960
Provider Name (Legal Business Name): SRB DME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 POOLE RD APT C1
WESTMINSTER MD
21157-6040
US

IV. Provider business mailing address

416 POOLE RD APT C1
WESTMINSTER MD
21157-6040
US

V. Phone/Fax

Practice location:
  • Phone: 432-243-4841
  • Fax:
Mailing address:
  • Phone: 432-243-4841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: RAZIA SHAHZADIE
Title or Position: CEO
Credential:
Phone: 432-243-4841