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General NPI Number Information
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NPI Number | 1730246034
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Entity Type | Organization
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Legal Business Name | RAINBOW MEDICAL SUPPLY, INC
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 402 MARYLAND AVE # C
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City | EASTON
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State | MD
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Zip | 21601-3438
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Country | US
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Telephone | 410-770-4955
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Fax |
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Provider Business Mailing Address
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Address Line | 402 MARYLAND AVE # C
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City | EASTON
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State | MD
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Zip | 21601-3438
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Country | US
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Telephone | 410-770-4955
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Fax |
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Authorized Official
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Title or Position | VP
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Name | PATRICK BRYAN TRAUTMAN
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Credential |
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Telephone | 410-770-4955
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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 | R2285
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License Number State | MD
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