Active NPI
Medical Company
- Oxygen Equipment & Supplies (DME)
- Woodbridge, VA
National Provider Identifier
1740464510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oxygen Equipment & Supplies (DME)
- License
- 0206009371
- Legal business name
- MEDICAL COMPANY
- Practice address
- 14555 Potomac Mills Rd
Woodbridge, VA 22192-6808 - Phone
- (703) 490-4114
- Fax
- (703) 490-8107
- NPI assigned
- Dec 28, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Annette Fleming McClatchey
- Title
- President/Ceo
- Phone
- (703) 490-4114
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 0206009371 | VA | |
| Oxygen Equipment & Supplies (DME) | 332BX2000X | 0206009371 | VA | Primary |
| Clinical Medical Laboratory | 291U00000X | VA |
Addresses
Primary practice location
14555 Potomac Mills Rd
Woodbridge, VA 22192-6808
Mailing address
PO Box 6577
Woodbridge, VA 22195-6577
Phone (703) 490-4114
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801950894 | Medicaid | VA |
Other names 1
- medical company
National Provider Directory
National Provider DirectoryLocations
14555 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 490-4114
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198800000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1198800000000",
"number": "1740464510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6577",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221956577",
"telephone_number": "703-490-4114",
"fax_number": "703-490-8107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14555 POTOMAC MILLS RD",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221926808",
"telephone_number": "703-490-4114",
"fax_number": "703-490-8107"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDICAL COMPANY",
"organizational_subpart": "NO",
"enumeration_date": "2007-12-28",
"last_updated": "2007-12-28",
"status": "A",
"authorized_official_last_name": "MCCLATCHEY",
"authorized_official_first_name": "ANNETTE",
"authorized_official_middle_name": "FLEMING",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "703-490-4114",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "VA",
"license": "0206009371",
"primary": false
},
{
"code": "332BX2000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
"state": "VA",
"license": "0206009371",
"primary": true
},
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "VA",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1801950894",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "medical company",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
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 Dec 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.