Servitium Med VA, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SERVITIUM MED VA, LLC

Practice address

4445 Corporation Lane Suite 291
Virginia Beach, VA 23462

Phone

(855) 210-4002

NPI assigned

Mar 29, 2017

Organization subpart

No

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

Authorized official

Name

Neil Francis Costello

Title

Manager

Phone

(855) 210-4002

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1801328810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 CORPORATION LANE SUITE 291",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23462",
            "telephone_number": "855-210-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 CORPORATION LANE SUITE 291",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23462",
            "telephone_number": "855-210-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERVITIUM MED VA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-29",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "855-210-4002"
    },
    "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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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.