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General NPI Number Information
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NPI Number | 1801232541
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Entity Type | Organization
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Legal Business Name | EMED MEDICAL SUPPLY, LLC
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Dates
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Enumeration Date | 05/21/2013
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Last Update Date | 10/23/2014
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Provider Practice Location Address
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Address Line | 504 CHARLES ST
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City | LA PLATA
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State | MD
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Zip | 20646-5931
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Country | US
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Telephone | 240-349-2129
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Fax | 240-349-2999
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Provider Business Mailing Address
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Address Line | 504 E. CHARLES ST.
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City | LA PLATA
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State | MD
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Zip | 20646
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Country | US
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Telephone | 240-349-2129
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Fax | 240-349-2999
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Authorized Official
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Title or Position | OWNER
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Name | MR. THOMAS FARQUHAR
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Credential |
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Telephone | 240-349-2129
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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 | 08702259
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License Number State | MD
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