Organization Active NPI

Medical Company

  • Oxygen Equipment & Supplies (DME)
  • Woodbridge, VA
National Provider Identifier
1740464510
Registry record updated Dec 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
License
0206009371 Issued in VA
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

Updated by the provider on Dec 28, 2007

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1801950894MedicaidVA

Other names 1

  • medical company Former legal business name

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.