Organization Active NPI

John J. Buchbach

  • Customized Equipment (DME)
  • Alexandria, VA
National Provider Identifier
1477587640
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
License
0622638 Issued in VA
Legal business name
JOHN J. BUCHBACH
Practice address
4944C Eisenhower Ave
Alexandria, VA 22304-4809
Phone
(703) 370-5790
Fax
(703) 370-5793
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Authorized official

Name
John Jacob Buchbach
Title
Owner
Phone
(703) 370-5790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X 0622638 VA Primary

Addresses

Primary practice location

4944C Eisenhower Ave
Alexandria, VA 22304-4809

Mailing address

4944C Eisenhower Ave
Alexandria, VA 22304-4809
Phone (703) 370-5790

Other identifiers 1

IdentifierTypeStateIssuer
009120335MedicaidVA

Other names 1

  • East Coast Rehab, LLC Other name

National Provider Directory

National Provider Directory

Locations

4944C Eisenhower Ave
Alexandria, VA 22304
Phone (703) 370-5790

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1477587640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4944C EISENHOWER AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223044809",
            "telephone_number": "703-370-5790",
            "fax_number": "703-370-5793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4944C EISENHOWER AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223044809",
            "telephone_number": "703-370-5790",
            "fax_number": "703-370-5793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN J. BUCHBACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "BUCHBACH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-370-5790"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "VA",
            "license": "0622638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009120335",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Coast Rehab, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.