AMERICOAST MARYLAND LLC; NPI #1154434819

Contact Information

AMERICOAST MARYLAND LLC

1310 INNOVATION ST STE H-L
MIDDLE RIVER, MD 21220-2179

Phone: 410-202-2784
Fax: 410-918-0633
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Oxygen Equipment & Supplies	332BX2000X	B1	Oxygen supplier
Parenteral & Enteral Nutrition	332BP3500X	87	All Other Suppliers

Indicates primary specialty

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NPI Profile & details for AMERICOAST MARYLAND LLC

NPI # 1154434819

LBN Legal business name AMERICOAST MARYLAND LLC

Authorized official WENDY RUSSALESI - (CCO)

Entity Organization

Organization subpart ¹ No

Enumeration date 08/16/2006

Last updated 12/12/2025 - About 6 months ago

Identifiers

MD	License #	D01734
MD	License #	R2267
DC	Medicaid	037170300
MD	Medicaid	407399100

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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