Healthcare Provider Details

I. General information

NPI: 1225081128
Provider Name (Legal Business Name): CHAIRMAN CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9502 RICHMOND HWY
LORTON VA
22079-2124
US

IV. Provider business mailing address

9502 RICHMOND HWY
LORTON VA
22079-2124
US

V. Phone/Fax

Practice location:
  • Phone: 703-447-7584
  • Fax: 703-450-0284
Mailing address:
  • Phone: 703-447-7584
  • Fax: 703-450-0284

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: MR. BASSEY EKANEM
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 703-447-7584