Healthcare Provider Details

I. General information

NPI: 1396188090
Provider Name (Legal Business Name): DM CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2013
Last Update Date: 03/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 SHAWNEE RD SUITE #101
ALEXANDRIA VA
22312-2311
US

IV. Provider business mailing address

5300 SHAWNEE RD SUITE #101
ALEXANDRIA VA
22312-2311
US

V. Phone/Fax

Practice location:
  • Phone: 703-354-4590
  • Fax: 703-354-4580
Mailing address:
  • Phone: 703-354-4590
  • Fax: 703-354-4580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number1103710
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MRS. MI KYUNG KIM
Title or Position: ADMINISTRATOR
Credential:
Phone: 703-354-4590