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General NPI Number Information
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NPI Number | 1376842609
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Entity Type | Organization
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Legal Business Name | TYCON MEDICAL SYSTEMS, INC
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Dates
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Enumeration Date | 03/25/2011
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Last Update Date | 05/03/2011
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Provider Practice Location Address
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Address Line | 334 EFFINGHAM ST
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City | PORTSMOUTH
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State | VA
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Zip | 23704-2306
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Country | US
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Telephone | 757-393-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 801 ORAPAX ST
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City | NORFOLK
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State | VA
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Zip | 23507-1323
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Country | US
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Telephone | 757-640-1709
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & OWNER
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Name | CHARLES C. TRAPANI
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Credential |
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Telephone | 757-640-1709
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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 | 0206009540
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License Number State | VA
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