MEDICARE: MD MEDICAL SUPPLY 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

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
2	11608411	OTHER	MD	CENTRAL REGISTRATION NUMBER

General Provider Information

NPI Number	:	1619913357
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MD MEDICAL SUPPLY INC

Provider Business Mailing Address
First Line	:	803 BARKWOOD CT STE F
Second Line	:
City	:	LINTHICUM HEIGHTS
State	:	MD
Zip	:	21090-1426
Country	:	US
Telephone Number	:	410-685-8159
Fax Number	:	410-685-8160

Provider Business Practice Location Address
First Line	:	803 BARKWOOD CT STE F
Second Line	:
City	:	LINTHICUM HEIGHTS
State	:	MD
Zip	:	21090-1426
Country	:	US
Telephone Number	:	410-685-8159
Fax Number	:	410-685-8160

Authorized Official
Title or Position	:	PRESIDENT
Name	:	OLGA SOBOLEVSKA
Credential	:
Telephone Number	:	443-642-7048

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	10/29/2024

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Directions to “MD MEDICAL SUPPLY INC ” Practice Location

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