Healthcare Provider Details

I. General information

NPI: 1932874096
Provider Name (Legal Business Name): EMERGILITY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2021
Last Update Date: 08/11/2021
Certification Date: 08/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4503 PENWOOD DR
ALEXANDRIA VA
22310-1463
US

IV. Provider business mailing address

4503 PENWOOD DR
ALEXANDRIA VA
22310-1463
US

V. Phone/Fax

Practice location:
  • Phone: 571-218-9265
  • Fax:
Mailing address:
  • Phone: 571-218-9265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ANTHONY BARONE
Title or Position: CEO & PROTECTIVE PARAMEDIC
Credential: MPS, MPH, NRP
Phone: 571-218-9265