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General NPI Number Information
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NPI Number | 1104002989
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Entity Type | Organization
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Legal Business Name | ACCESS MEDICAL SUPPLY
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Dates
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Enumeration Date | 01/11/2008
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Last Update Date | 01/22/2008
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Provider Practice Location Address
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Address Line | 10620 SPOTSYLVANIA AVE UNIT 2
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City | FREDERICKSBURG
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State | VA
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Zip | 22408-2637
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Country | US
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Telephone | 540-710-5416
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Fax | 540-710-5417
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Provider Business Mailing Address
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Address Line | 4801 QUEENSBURY CIR
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City | FREDERICKSBURG
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State | VA
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Zip | 22408-1821
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Country | US
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Telephone | 540-842-6397
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Fax | 540-710-5417
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Authorized Official
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Title or Position | OWNER
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Name | MR. NNADOZIE I NWACHUKU
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Credential |
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Telephone | 540-710-5416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 104910
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License Number State | VA
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