Basic Information
Provider Information
NPI: 1952962052
EntityType: 2
ReplacementNPI:  
OrganizationName: GREENBELT DME LLC
LastName:  
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Mailing Information
Address1: 7474 GREENWAY CENTER DR STE 1000
Address2:  
City: GREENBELT
State: MD
PostalCode: 207703500
CountryCode: US
TelephoneNumber: 8558308346
FaxNumber: 2404734321
Practice Location
Address1: 108 FORBES ST
Address2:  
City: ANNAPOLIS
State: MD
PostalCode: 214011502
CountryCode: US
TelephoneNumber: 8558308346
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/28/2019
LastUpdateDate: 06/28/2019
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: LAKHANPAL
AuthorizedOfficialFirstName: SANJIV
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 8558308346
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332B00000X  Y SuppliersDurable Medical Equipment & Medical Supplies 

No ID Information.


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