Provider Demographics
NPI:1326086901
Name:ADTS, INC.
Entity Type:Organization
Organization Name:ADTS, INC.
Other - Org Name:PRINCE WILLIAM HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SYDNEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:FORTUNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-361-4211
Mailing Address - Street 1:PO BOX 1070
Mailing Address - Street 2:5037 HALIFAX ROAD
Mailing Address - City:HALIFAX
Mailing Address - State:VA
Mailing Address - Zip Code:24558-3185
Mailing Address - Country:US
Mailing Address - Phone:434-572-1682
Mailing Address - Fax:434-572-1682
Practice Address - Street 1:8724 SUDLEY ROAD
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4405
Practice Address - Country:US
Practice Address - Phone:703-361-4211
Practice Address - Fax:703-361-0028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0206008374332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
295749OtherAMERIGROUP
VA009119434Medicaid
VA235085OtherBCBS
1278710001Medicare ID - Type Unspecified