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General NPI Number Information
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NPI Number | 1982837951
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Entity Type | Organization
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Legal Business Name | MEGA TECH CONSTRUCTION CORPORATION
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Dates
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Enumeration Date | 08/25/2009
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Last Update Date | 08/25/2009
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Provider Practice Location Address
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Address Line | 3405 MONARCH LN
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City | ANNANDALE
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State | VA
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Zip | 22003-1156
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Country | US
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Telephone | 703-955-1041
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Fax | 703-876-0355
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Provider Business Mailing Address
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Address Line | 3405 MONARCH LN
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City | ANNANDALE
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State | VA
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Zip | 22003-1156
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Country | US
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Telephone | 703-955-1041
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Fax | 703-876-0355
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Authorized Official
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Title or Position | CONTRACTOR
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Name | MR. YONG JOON PARK
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Credential |
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Telephone | 703-955-1041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 2705073655A
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License Number State | VA
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