Provider Demographics
NPI:1386699221
Name:MARYLAND SUPPLY & EQUIPMENT CO. INC
Entity type:Organization
Organization Name:MARYLAND SUPPLY & EQUIPMENT CO. INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VLADISLAV
Authorized Official - Middle Name:
Authorized Official - Last Name:PODZIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-363-2279
Mailing Address - Street 1:PO BOX 546
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-0546
Mailing Address - Country:US
Mailing Address - Phone:410-363-2279
Mailing Address - Fax:410-363-4315
Practice Address - Street 1:718 MAIN ST
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-2502
Practice Address - Country:US
Practice Address - Phone:410-363-2279
Practice Address - Fax:410-363-4315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03183347332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD075540100Medicare NSC
MD1237060001Medicare NSC