Provider Demographics
NPI:1316086234
Name:EUTAW ORTHOPEDIC SUPPLY CO
Entity type:Organization
Organization Name:EUTAW ORTHOPEDIC SUPPLY CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-654-8578
Mailing Address - Street 1:PO BOX 229
Mailing Address - Street 2:
Mailing Address - City:STEVENSON
Mailing Address - State:MD
Mailing Address - Zip Code:21153-0229
Mailing Address - Country:US
Mailing Address - Phone:410-363-8799
Mailing Address - Fax:410-363-8739
Practice Address - Street 1:8002 VALLEY MANOR RD
Practice Address - Street 2:UNIT 1A
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5354
Practice Address - Country:US
Practice Address - Phone:410-363-8799
Practice Address - Fax:410-363-8739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies