MEDICARE: TOTALLY 4-U, LLC

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	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1134942139
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTALLY 4-U, LLC

Provider Business Mailing Address
First Line	:	9660 GUILFORD RD
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21046-1999
Country	:	US
Telephone Number	:	410-960-3280
Fax Number	:

Provider Business Practice Location Address
First Line	:	3407 FORT MEADE RD STE 4
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20724-2003
Country	:	US
Telephone Number	:	410-960-3280
Fax Number	:

Authorized Official
Title or Position	:	CRANIAL PROSTHETIC SPECIALIST
Name	:	MS. LORETTA DENISE THORPE
Credential	:
Telephone Number	:	410-960-3280

Provider Enumeration Date	:	11/06/2024
Last Update Date	:	11/06/2024

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