Provider Demographics
NPI:1003851601
Name:UNITED MEDICAL SUPPLIES INC.
Entity Type:Organization
Organization Name:UNITED MEDICAL SUPPLIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:LILIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ISSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-277-3369
Mailing Address - Street 1:10507 BRADDOCK RD STE A
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-2240
Mailing Address - Country:US
Mailing Address - Phone:703-277-3369
Mailing Address - Fax:703-277-9606
Practice Address - Street 1:10507 BRADDOCK RD STE A
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22032-2240
Practice Address - Country:US
Practice Address - Phone:703-277-3369
Practice Address - Fax:703-277-9606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5407290001Medicare ID - Type Unspecified