Healthcare Provider Details

I. General information

NPI: 1013665413
Provider Name (Legal Business Name): ONE HOME MEDICAL EQUIPMENT VA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2022
Last Update Date: 03/15/2022
Certification Date: 03/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6545 COMMONWEALTH DR
CAVE SPRING VA
24018-5160
US

IV. Provider business mailing address

3351 EXECUTIVE WAY
MIRAMAR FL
33025-3935
US

V. Phone/Fax

Practice location:
  • Phone: 540-266-3724
  • Fax: 855-441-6941
Mailing address:
  • Phone: 954-842-5775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: RYAN COCHRAN
Title or Position: CFO
Credential:
Phone: 561-350-7121