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NPI Code Detail

MEDICARE: D&T MED VA LLC

MEDICARE: D&T MED VA 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
1343900000XNon-emergency Medical Transport (VAN)

General Provider Information

NPI Number : 1376179069
Entity Type Code : Organization
Provider Name (Legal Business Name) : D&T MED VA LLC
Provider Business Mailing Address
First Line : 4250 FAIRFAX DR STE 600
Second Line :
City : ARLINGTON
State : VA
Zip : 22203-1665
Country : US
Telephone Number : 210-442-8431
Fax Number :
Provider Business Practice Location Address
First Line : 4250 FAIRFAX DR STE 600
Second Line :
City : ARLINGTON
State : VA
Zip : 22203-1665
Country : US
Telephone Number : 210-442-8431
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : DANIEL GEBERMICHAEL
Credential :
Telephone Number : 210-442-8431
Provider Enumeration Date : 03/13/2020
Last Update Date : 03/13/2020

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Directions to “D&T MED VA LLC ” Practice Location

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