Provider Demographics
NPI:1497162549
Name:AMERICAN CMG SERVICES, INC.
Entity Type:Organization
Organization Name:AMERICAN CMG SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:DIMAANO
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-548-5656
Mailing Address - Street 1:1521 TECHNOLOGY DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-5974
Mailing Address - Country:US
Mailing Address - Phone:757-548-5656
Mailing Address - Fax:757-548-5657
Practice Address - Street 1:750 LOMBARDY ST
Practice Address - Street 2:
Practice Address - City:SOUTH HILL
Practice Address - State:VA
Practice Address - Zip Code:23970-2112
Practice Address - Country:US
Practice Address - Phone:434-774-2506
Practice Address - Fax:757-548-5657
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN CMG SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-21
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9110208Medicaid