Provider Demographics
NPI:1538925110
Name:1 HEART MEDICAL SUPPLIES LLC
Entity type:Organization
Organization Name:1 HEART MEDICAL SUPPLIES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-432-9617
Mailing Address - Street 1:12262 LAVACA CT STE 100
Mailing Address - Street 2:
Mailing Address - City:LUSBY
Mailing Address - State:MD
Mailing Address - Zip Code:20657-3700
Mailing Address - Country:US
Mailing Address - Phone:667-321-9741
Mailing Address - Fax:
Practice Address - Street 1:5015 SAINT LEONARD RD STE 5
Practice Address - Street 2:
Practice Address - City:SAINT LEONARD
Practice Address - State:MD
Practice Address - Zip Code:20685-2817
Practice Address - Country:US
Practice Address - Phone:667-321-9741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies