Green Valley DME LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GREEN VALLEY DME LLC

Practice address

3957 Pender Dr
Suite 104
Fairfax, VA 22030-6027

Phone

(703) 865-5595

Fax

(703) 995-4543

NPI assigned

Mar 22, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Ehab Shafik

Title

President

Phone

(703) 865-5595

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1363910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455667200000",
    "number": "1043552599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3949 PENDER DR STE 140",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306088",
            "telephone_number": "703-865-5595",
            "fax_number": "703-995-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3957 PENDER DR",
            "address_2": "SUITE 104",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306027",
            "telephone_number": "703-865-5595",
            "fax_number": "703-995-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN VALLEY DME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-22",
        "last_updated": "2016-02-17",
        "status": "A",
        "authorized_official_last_name": "SHAFIK",
        "authorized_official_first_name": "EHAB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-865-5595",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Joan Green
• Edward David Greenberg, M.D.

• Durable Medical Equipment & Medical Supplies in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Durable Medical Equipment & Medical Supplies in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.