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General NPI Number Information
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NPI Number | 1396329579
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Entity Type | Organization
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Legal Business Name | POTOMAC VALLEY HOME MEDICAL INC.
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Dates
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Enumeration Date | 05/12/2021
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Last Update Date | 05/12/2021
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Provider Practice Location Address
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Address Line | 6310 STEVENS FOREST RD
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City | COLUMBIA
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State | MD
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Zip | 21046-1036
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Country | US
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Telephone | 301-722-6300
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Fax | 301-722-4787
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Provider Business Mailing Address
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Address Line | 6721 SERVICEBERRY DR
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City | FREDERICK
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State | MD
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Zip | 21703-7996
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Country | US
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Telephone | 240-644-8664
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Fax | 301-722-4787
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Authorized Official
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Title or Position | PRESIDENT
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Name | WALEED ADNAN BEIDAS
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Credential |
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Telephone | 301-722-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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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 | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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