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General NPI Number Information
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NPI Number | 1326491184
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Entity Type | Organization
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Legal Business Name | MEGA PROTECT SERVICES LLC
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Dates
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Enumeration Date | 07/18/2016
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Last Update Date | 10/14/2020
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Provider Practice Location Address
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Address Line | 1950 OPITZ BLVD # 2
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City | WOODBRIDGE
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State | VA
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Zip | 22191-3304
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Country | US
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Telephone | 571-408-4004
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Fax | 703-986-3139
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Provider Business Mailing Address
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Address Line | 1950 OPITZ BLVD STREET ADDRESS 2
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City | WOODBRIDGE
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State | VA
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Zip | 22191-2371
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Country | US
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Telephone | 571-408-4004
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Fax | 703-986-3139
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL OLATUNJI
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Credential |
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Telephone | 571-278-4271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | S4092401
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License Number State | VA
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