Healthcare Provider Details

I. General information

NPI: 1922862101
Provider Name (Legal Business Name): ZIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2024
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7420 HERITAGE VILLAGE PLZ UNIT 101
GAINESVILLE VA
20155-3302
US

IV. Provider business mailing address

7420 HERITAGE VILLAGE PLZ UNIT 101
GAINESVILLE VA
20155-3302
US

V. Phone/Fax

Practice location:
  • Phone: 877-203-1580
  • Fax:
Mailing address:
  • Phone: 877-203-1580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ANDREW OPPENHEIM
Title or Position: OWNER
Credential:
Phone: 703-466-0259