Provider Demographics
NPI:1508453911
Name:CONSULTING CONNECTION SERVICES LLC
Entity Type:Organization
Organization Name:CONSULTING CONNECTION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:TATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-843-8556
Mailing Address - Street 1:PO BOX 1132
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-9132
Mailing Address - Country:US
Mailing Address - Phone:703-843-8556
Mailing Address - Fax:703-214-6239
Practice Address - Street 1:4315 GOLDEN GATE WAY
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22025-2026
Practice Address - Country:US
Practice Address - Phone:571-389-3630
Practice Address - Fax:703-214-6239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0706401392Medicaid
VA0950518800Medicaid