Healthcare Provider Details

I. General information

NPI: 1154895449
Provider Name (Legal Business Name): XENSAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2019
Last Update Date: 06/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6547 ORLAND ST
FALLS CHURCH VA
22043-1813
US

IV. Provider business mailing address

818 OAKWOOD ST
OJAI CA
93023-3567
US

V. Phone/Fax

Practice location:
  • Phone: 571-220-6208
  • Fax:
Mailing address:
  • Phone: 571-220-6208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: ANKASH BADAMI
Title or Position: CEO
Credential:
Phone: 703-777-4429