Provider Demographics
NPI:1316123870
Name:METROPOLITAN MEDICAL SUPPLIES LLC
Entity type:Organization
Organization Name:METROPOLITAN MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDEM
Authorized Official - Middle Name:EDET
Authorized Official - Last Name:AKPANDAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-519-0999
Mailing Address - Street 1:610 PROFESSIONAL DR
Mailing Address - Street 2:SUITE 240
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-3413
Mailing Address - Country:US
Mailing Address - Phone:301-519-0999
Mailing Address - Fax:301-519-0666
Practice Address - Street 1:610 PROFESSIONAL DR
Practice Address - Street 2:SUITE 240
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-3413
Practice Address - Country:US
Practice Address - Phone:301-519-0999
Practice Address - Fax:301-519-0666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2166332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD414597600Medicaid
DC039710500Medicaid
DC039710500Medicaid