=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518020221
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JUST IN TIME MEDICAL SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/18/2006
-----------------------------------------------------
Last Update Date | 06/03/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8301 ARLINGTON BLVD SUITE 107
-----------------------------------------------------
City | FAIRFAX
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22031-2902
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-204-0001
-----------------------------------------------------
Fax | 703-204-0035
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8301 ARLINGTON BLVD SUITE 107
-----------------------------------------------------
City | FAIRFAX
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22031-2902
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-204-0001
-----------------------------------------------------
Fax | 703-204-0035
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | IKE J NWEKE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 703-204-0001
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 89387
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------