| Organization Name: | WESTERN MARYLAND MEDICAL SUPPLY |
| NPI Number: | 1306863360 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS T CHAN (CFO) |
| Mailing Address: | 12101 Winchester Rd Suite 1a Lavale |
| State: | MD US |
| Postal Code: | 215027688 |
| Phone Number: | 3017294280 |
| Fax Number: | 3017292944 |
| NPI Enumeration Date: | 07/16/2006 |
| NPI Last Update Date: | 03/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | R1119 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |