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NPI Code Detail

MEDICARE: ZIVAN MEDICAL SUPPLY LLC

MEDICARE: ZIVAN MEDICAL SUPPLY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1134078306
Entity Type Code : Organization
Provider Name (Legal Business Name) : ZIVAN MEDICAL SUPPLY LLC
Provider Business Mailing Address
First Line : 2611 S CLARK ST
Second Line :
City : ARLINGTON
State : VA
Zip : 22202-4016
Country : US
Telephone Number : 571-200-9717
Fax Number :
Provider Business Practice Location Address
First Line : 2611 S CLARK ST
Second Line :
City : ARLINGTON
State : VA
Zip : 22202-4016
Country : US
Telephone Number : 571-200-9717
Fax Number :
Authorized Official
Title or Position : CEO
Name : NELLY MAINA
Credential :
Telephone Number : 571-200-9717
Provider Enumeration Date : 01/22/2026
Last Update Date : 01/22/2026

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Directions to “ZIVAN MEDICAL SUPPLY LLC ” Practice Location

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