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General NPI Number Information
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NPI Number | 1992946982
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Entity Type | Organization
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Legal Business Name | SLJS, INC.
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Dates
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Enumeration Date | 03/20/2009
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Last Update Date | 03/20/2009
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Provider Practice Location Address
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Address Line | 1321 ALUM SPRING RD
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-7001
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Country | US
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Telephone | 540-371-0512
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Fax | 540-371-7364
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Provider Business Mailing Address
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Address Line | PO BOX 741
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City | FREDERICKSBURG
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State | VA
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Zip | 22404-0741
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Country | US
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Telephone | 540-371-0512
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Fax | 540-371-7364
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MRS. LINDA W SPRATT
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Credential |
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Telephone | 540-371-0512
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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 | 2705 026871A
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License Number State | VA
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