Provider Demographics
NPI:1366281081
Name:CHARM CITY MEDICAL EQUIPMENT & SUPPLIES, LLC.
Entity type:Organization
Organization Name:CHARM CITY MEDICAL EQUIPMENT & SUPPLIES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / DME SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KONTOROVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-725-9006
Mailing Address - Street 1:110 PAINTERS MILL RD STE 207
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5251
Mailing Address - Country:US
Mailing Address - Phone:646-725-9006
Mailing Address - Fax:
Practice Address - Street 1:110 PAINTERS MILL RD STE 207
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5251
Practice Address - Country:US
Practice Address - Phone:646-725-9006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies