Provider Demographics
NPI:1275771842
Name:RITETIME MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:RITETIME MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EMEKA
Authorized Official - Middle Name:JUDE
Authorized Official - Last Name:OKIBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-430-6664
Mailing Address - Street 1:207 E HOLLY AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20164-3137
Mailing Address - Country:US
Mailing Address - Phone:703-430-6664
Mailing Address - Fax:
Practice Address - Street 1:207 E HOLLY AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20164-3137
Practice Address - Country:US
Practice Address - Phone:703-430-6664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD021373000Medicaid
VA1275771842Medicaid
VA1275771842Medicaid