Provider Demographics
NPI:1679259311
Name:BANNER MEDICAL EQUIPMENT & SUPPLIES
Entity type:Organization
Organization Name:BANNER MEDICAL EQUIPMENT & SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:UCHE
Authorized Official - Middle Name:LUCY
Authorized Official - Last Name:OKEKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-650-9302
Mailing Address - Street 1:10258 LAKE ARBOR WAY
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-3132
Mailing Address - Country:US
Mailing Address - Phone:844-850-8500
Mailing Address - Fax:
Practice Address - Street 1:10258 LAKE ARBOR WAY
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-3132
Practice Address - Country:US
Practice Address - Phone:844-850-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies