Healthcare Provider Details

I. General information

NPI: 1750738670
Provider Name (Legal Business Name): UNIVERSAL MOBILE HEALTHCARE SYSTEMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2016
Last Update Date: 10/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1231 TECH CT
WESTMINSTER MD
21157-3029
US

IV. Provider business mailing address

1231 TECH CT
WESTMINSTER MD
21157-3029
US

V. Phone/Fax

Practice location:
  • Phone: 443-254-5046
  • Fax: 443-293-7157
Mailing address:
  • Phone: 443-254-5046
  • Fax: 443-293-7157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPW0498
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHE CARMEL TAPA WAMBO
Title or Position: PRESIDENT
Credential:
Phone: 443-821-7969