Provider Demographics
NPI:1861799249
Name:FIRST DURABLE MEDICAL SUPPLY
Entity type:Organization
Organization Name:FIRST DURABLE MEDICAL SUPPLY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIMITOGLOU
Authorized Official - Suffix:
Authorized Official - Credentials:DSC
Authorized Official - Phone:301-332-5914
Mailing Address - Street 1:250 W PATRICK ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-6945
Mailing Address - Country:US
Mailing Address - Phone:301-228-3370
Mailing Address - Fax:301-228-3371
Practice Address - Street 1:250 W PATRICK ST
Practice Address - Street 2:SUITE 1
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-6945
Practice Address - Country:US
Practice Address - Phone:301-228-3370
Practice Address - Fax:301-228-3371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-20
Last Update Date:2011-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies