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General NPI Number Information
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NPI Number | 1215041983
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Entity Type | Organization
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Legal Business Name | MEDSTAR HEALTH INFUSION, INC.
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 04/29/2009
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Provider Practice Location Address
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Address Line | 7379 WASHINGTON BLVD
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City | ELKRIDGE
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State | MD
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Zip | 21075-6329
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Country | US
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Telephone | 410-540-4450
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Fax | 410-540-4430
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Provider Business Mailing Address
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Address Line | 7379 WASHINGTON BLVD
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City | ELKRIDGE
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State | MD
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Zip | 21075-6329
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Country | US
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Telephone | 410-540-4450
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Fax | 410-540-4430
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. CARMEN LOTT
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Credential | RN
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Telephone | 410-540-4419
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | PW0199
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License Number State | MD
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