Healthcare Provider Details

I. General information

NPI: 1578335287
Provider Name (Legal Business Name): MEDINEEDS MEDTOUR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2023
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2611 S CLARK ST STE 600
ARLINGTON VA
22202-4023
US

IV. Provider business mailing address

11429 DUNLORING PL
UPPER MARLBORO MD
20774-5758
US

V. Phone/Fax

Practice location:
  • Phone: 703-972-5004
  • Fax: 703-995-4846
Mailing address:
  • Phone: 240-755-3272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: OLAMIDOTUN OMOLOSO
Title or Position: MD
Credential:
Phone: 240-755-3272