Provider Demographics
NPI:1861904674
Name:LIFETIME MEDICAL SERVICES
Entity type:Organization
Organization Name:LIFETIME MEDICAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSHODI
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:301-362-3601
Mailing Address - Street 1:312 MARSHALL AVE STE 1001B
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4824
Mailing Address - Country:US
Mailing Address - Phone:301-362-3601
Mailing Address - Fax:
Practice Address - Street 1:312 MARSHALL AVE STE 1001B
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4824
Practice Address - Country:US
Practice Address - Phone:301-362-3601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-02
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies