Provider Demographics
NPI:1962432666
Name:DISTRICT HEALTHCARE & JANITORIAL SUPPLIES, INC.
Entity type:Organization
Organization Name:DISTRICT HEALTHCARE & JANITORIAL SUPPLIES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PERNELL
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-333-1750
Mailing Address - Street 1:10104 SENATE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4393
Mailing Address - Country:US
Mailing Address - Phone:301-918-0200
Mailing Address - Fax:301-918-8230
Practice Address - Street 1:10104 SENATE DR STE 201
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4393
Practice Address - Country:US
Practice Address - Phone:301-918-0200
Practice Address - Fax:301-918-8230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
MD16226054332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD40801OtherAMERIGROUP
DC207060000OtherTRICARE
DC025842500Medicaid
VA009106081Medicaid
MD648588000Medicaid
MD40801OtherAMERIGROUP