NPIMap

Organization Active NPI

LG Medical Supplies LLC

  • Durable Medical Equipment & Medical Supplies
  • Woodbridge, VA
National Provider Identifier
1417217621
Registry record updated Jul 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
LG MEDICAL SUPPLIES LLC
Practice address
3108 PS Business Center Dr
Woodbridge, VA 22192-4258
Phone
(703) 670-3925
Fax
(703) 670-3924
NPI assigned
May 22, 2012
Last updated
Jul 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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

Authorized official

Name
Gina O AgyemanNPI 1073861662
Title
Ceo
Phone
(703) 670-3925

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

3108 PS Business Center Dr
Woodbridge, VA 22192-4258

Mailing address

6205 Tarberry PL
Woodbridge, VA 22193-4195
Phone (571) 490-2187

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343174400000",
    "number": "1417217621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6205 TARBERRY PL",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221934195",
            "telephone_number": "571-490-2187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 PS BUSINESS CENTER DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924258",
            "telephone_number": "703-670-3925",
            "fax_number": "703-670-3924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LG MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-22",
        "last_updated": "2012-07-25",
        "status": "A",
        "authorized_official_last_name": "AGYEMAN",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "703-670-3925"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; 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.