Provider Demographics
NPI:1487973467
Name:TUNERUTH MEDICAL SUPPLY
Entity type:Organization
Organization Name:TUNERUTH MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:OKWARA-BABAYEMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-409-6299
Mailing Address - Street 1:6495 NEW HAMPSHIRE AVE
Mailing Address - Street 2:SUITE C603
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-3245
Mailing Address - Country:US
Mailing Address - Phone:202-409-6299
Mailing Address - Fax:202-291-2346
Practice Address - Street 1:6495 NEW HAMPSHIRE AVE
Practice Address - Street 2:SUITE C603
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-3245
Practice Address - Country:US
Practice Address - Phone:202-409-6299
Practice Address - Fax:202-291-2346
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUNERUTH MEDICAL SUPPLY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-30
Last Update Date:2010-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2922332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies