Provider Demographics
NPI:1861990947
Name:VESPER MEDICAL TRANSPORT OF MARYLAND
Entity type:Organization
Organization Name:VESPER MEDICAL TRANSPORT OF MARYLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SUSALLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-495-8888
Mailing Address - Street 1:PO BOX 38746
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-8746
Mailing Address - Country:US
Mailing Address - Phone:330-495-8888
Mailing Address - Fax:
Practice Address - Street 1:23 HENRY FORD CIR
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3713
Practice Address - Country:US
Practice Address - Phone:330-495-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-24
Last Update Date:2024-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance