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General NPI Number Information
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NPI Number | 1497924898
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Entity Type | Organization
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Legal Business Name | STATS MEDICAL SUPPLIES & EQUIPMENT
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Dates
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Enumeration Date | 02/29/2008
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Last Update Date | 04/18/2011
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Provider Practice Location Address
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Address Line | 10760 HICKORY RIDGE RD SUITE 123
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City | COLUMBIA
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State | MD
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Zip | 21044-3682
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Country | US
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Telephone | 301-617-0066
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Fax | 443-542-9372
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Provider Business Mailing Address
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Address Line | 10760 HICKORY RIDGE RD SUITE 123
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City | COLUMBIA
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State | MD
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Zip | 21044-3682
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Country | US
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Telephone | 301-617-0066
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Fax | 443-542-9372
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Authorized Official
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Title or Position | CEO
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Name | MRS. OLUSHOLA E FASHINA
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Credential |
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Telephone | 301-617-0066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | R2412
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License Number State | MD
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