Healthcare Provider Details

I. General information

NPI: 1851772578
Provider Name (Legal Business Name): DREAM CARE OF VA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2015
Last Update Date: 12/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8002 DISCOVERY DR RM 110A
RICHMOND VA
23229-8601
US

IV. Provider business mailing address

3325 BARTLETT BLVD
ORLANDO FL
32811-6428
US

V. Phone/Fax

Practice location:
  • Phone: 804-286-1842
  • Fax:
Mailing address:
  • Phone: 407-206-0040
  • 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: MR. STEPHEN GRIGGS
Title or Position: CEO
Credential:
Phone: 407-206-0040