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General NPI Number Information
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NPI Number | 1154878502
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Entity Type | Organization
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Legal Business Name | DME DISTRIBUTORS LLC
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 9818 SPILLWAY CT
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City | BURKE
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State | VA
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Zip | 22015-1835
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Country | US
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Telephone | 703-881-1082
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Fax | 703-310-6877
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Provider Business Mailing Address
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Address Line | 9818 SPILLWAY CT
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City | BURKE
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State | VA
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Zip | 22015-1835
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Country | US
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Telephone | 703-881-1082
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Fax | 703-310-6877
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Authorized Official
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Title or Position | OWNER
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Name | MS. LISA QUINN HARRISON
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Credential |
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Telephone | 703-881-1082
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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 | 16-DMED
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License Number State | VA
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