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General NPI Number Information
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NPI Number | 1568611804
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Entity Type | Organization
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Legal Business Name | ABBA MEDICAL SUPPLIES CORPORATION
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Dates
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Enumeration Date | 09/11/2008
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Last Update Date | 03/23/2010
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Provider Practice Location Address
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Address Line | 142 W MAIN ST
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City | ELKTON
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State | MD
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Zip | 21921-5541
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Country | US
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Telephone | 443-485-6804
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Fax | 443-485-6805
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Provider Business Mailing Address
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Address Line | 239 S BRIDGE ST
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City | ELKTON
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State | MD
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Zip | 21921-5951
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Country | US
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Telephone | 443-350-9094
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Fax | 443-350-9092
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. AKINOLA HANSON ADEJUWON
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Credential |
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Telephone | 302-478-5294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 07282649
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License Number State | MD
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