Provider Demographics
NPI:1194414219
Name:SOUTH POINT MEDICAL SOLUTIONS, LLC
Entity type:Organization
Organization Name:SOUTH POINT MEDICAL SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIAK
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:410-358-2518
Mailing Address - Street 1:5 PARK CENTER CT STE 200
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4202
Mailing Address - Country:US
Mailing Address - Phone:410-358-2518
Mailing Address - Fax:410-358-0093
Practice Address - Street 1:5 PARK CENTER CT STE 200
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4202
Practice Address - Country:US
Practice Address - Phone:410-358-2518
Practice Address - Fax:410-358-0093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies