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General NPI Number Information
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NPI Number | 1669428124
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Entity Type | Organization
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Legal Business Name | GRANDIFF MEDICAL SUPPLIES INC
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 20 VITAL WAY
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City | SILVER SPRING
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State | MD
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Zip | 20904-3446
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Country | US
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Telephone | 301-388-0596
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Fax | 301-388-0597
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Provider Business Mailing Address
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Address Line | 20 VITAL WAY
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City | SILVER SPRING
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State | MD
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Zip | 20904-3446
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Country | US
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Telephone | 301-388-0596
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Fax | 301-388-0597
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Authorized Official
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Title or Position | DIRECTOR
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Name | IMAOBONG NNSEWO AKPAETE
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Credential |
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Telephone | 301-388-0596
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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 | R2253
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License Number State | MD
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