Provider Demographics
NPI:1104072792
Name:ABSOLUTE INNOVATIONS
Entity type:Organization
Organization Name:ABSOLUTE INNOVATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:TRAUTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-253-9601
Mailing Address - Street 1:9010 HIGH BANKS DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-6832
Mailing Address - Country:US
Mailing Address - Phone:410-822-3106
Mailing Address - Fax:
Practice Address - Street 1:9010 HIGH BANKS DR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-6832
Practice Address - Country:US
Practice Address - Phone:410-822-3106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD018675900Medicaid