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General NPI Number Information
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NPI Number | 1114939360
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Entity Type | Organization
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Legal Business Name | CAPITAL MEDICAL SUPPLY INC
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 03/23/2011
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Provider Practice Location Address
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Address Line | 2233 TOMLYNN RD
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City | RICHMOND
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State | VA
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Zip | 23230-3334
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Country | US
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Telephone | 804-353-0707
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Fax |
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Provider Business Mailing Address
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Address Line | 2233 TOMLYNN RD
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City | RICHMOND
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State | VA
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Zip | 23230-3334
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Country | US
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Telephone | 804-353-0707
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHARD NELSON BERRY
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Credential |
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Telephone | 804-353-0707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 0206009283
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License Number State | VA
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