Healthcare Provider Details

I. General information

NPI: 1265550792
Provider Name (Legal Business Name): NATIONAL PHYSICIAN CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3347 BROOKFIELD CORPROATE DR. 203
CHANTILLY VA
20151
US

IV. Provider business mailing address

PO BOX 70962
MARIETTA GA
30007-0962
US

V. Phone/Fax

Practice location:
  • Phone: 703-961-0733
  • Fax: 703-961-0732
Mailing address:
  • Phone: 770-321-1772
  • Fax: 770-321-5658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number9105832
License Number StateVA

VIII. Authorized Official

Name: MR. RICHARD L. MILES
Title or Position: PRESIDENT
Credential:
Phone: 770-321-1772