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General NPI Number Information
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NPI Number | 1164479689
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Entity Type | Organization
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Legal Business Name | JOSEPHINE'S DURABLE MEDICAL EQUP. SUPPLIES
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Dates
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Enumeration Date | 05/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 23 DEFENSE DR
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City | ABERDEEN
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State | MD
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Zip | 21001-3805
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Country | US
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Telephone | 410-306-6017
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Fax | 410-306-6117
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Provider Business Mailing Address
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Address Line | 23 DEFENSE DR
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City | ABERDEEN
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State | MD
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Zip | 21001-3805
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Country | US
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Telephone | 410-306-6017
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Fax | 410-306-6117
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JOSEPHINE SANTUCCI
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Credential |
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Telephone | 410-306-6017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 12203407
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License Number State | MD
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