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General NPI Number Information
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NPI Number | 1629493218
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Entity Type | Organization
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Legal Business Name | BIO-MEDICAL APPLICATIONS OF VIRGINIA, INC.
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Dates
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Enumeration Date | 02/19/2014
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Last Update Date | 02/18/2021
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Provider Practice Location Address
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Address Line | 6161 KEMPSVILLE CIR STE 155
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City | NORFOLK
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State | VA
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Zip | 23502-3950
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Country | US
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Telephone | 757-461-9422
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Fax | 757-459-8093
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Provider Business Mailing Address
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Address Line | 6161 KEMPSVILLE CIR STE 155
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City | NORFOLK
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State | VA
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Zip | 23502-3950
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Country | US
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Telephone | 757-461-9422
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Fax | 757-459-8093
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | JAMES J. DIVITO
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Credential |
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Telephone | 781-699-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State | VA
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