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General NPI Number Information
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NPI Number | 1245752823
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Entity Type | Organization
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Legal Business Name | POWERS DISTRIBUTION LLC
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Dates
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Enumeration Date | 07/14/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2109 PATRICK ST
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City | WOODBRIDGE
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State | VA
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Zip | 22191-2532
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Country | US
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Telephone | 571-402-1864
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Fax | 571-364-7398
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Provider Business Mailing Address
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Address Line | 2109 PATRICK ST
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City | WOODBRIDGE
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State | VA
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Zip | 22191-2532
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Country | US
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Telephone | 571-402-1864
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Fax | 571-364-7398
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARITZA V POWERS
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Credential |
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Telephone | 571-402-1864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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