FABULOUS WEAVE LLC NPI 1083960801

NPI Information

  • NPI: 1083960801
  • Provider Name: FABULOUS WEAVE , LLC
  • Classification: Durable Medical Equipment & Medical Supplies - 332BC3200X
  • Specialization: Customized Equipment
  • Entity Type: Organization
  • Address: 10595 SOURWOOD AVE
    WALDORF, MD
    ZIP 20603
  • Phone: (301) 645-8765

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NPI Details

FABULOUS WEAVE , LLC is a customized equipment durable medical equipment medical supplies in Waldorf, MD. FABULOUS WEAVE , LLC NPI is 1083960801. The provider is registered as an organization entity type.

The provider's business location address is:

10595 SOURWOOD AVE
WALDORF, MD
ZIP 20603-730
Phone: (301) 645-8765
Fax: (301) 645-9611

The provider's authorized official is Andrea Doctor .
The authorized official title is Rnconsult For Cranial Prosthesis and has the following contact phone number (301) 609-0845.

The enumeration date for this NPI number is 7/30/2012 and was last updated on 7/30/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332BC3200XDurable Medical Equipment & Medical SuppliesCustomized EquipmentYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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