MEDICARE: FRAN'S NU IMAGE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	08195359	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114108032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRAN'S NU IMAGE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 995
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20604-0995
Country	:	US
Telephone Number	:	301-843-9282
Fax Number	:	301-645-2131

Provider Business Practice Location Address
First Line	:	11705 BERRY ROAD
Second Line	:	THE BARLEY BUILDING , SUITE 303
City	:	WALDORF
State	:	MD
Zip	:	20603-5933
Country	:	US
Telephone Number	:	301-843-9282
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CERTIFIED FITTER
Name	:	MARI-FRANCES QUADE
Credential	:	CMF
Telephone Number	:	301-843-9282

Provider Enumeration Date	:	11/20/2007
Last Update Date	:	07/21/2022

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