Provider Demographics
NPI:1518486828
Name:PWC HOME MEDICAL SUPPLY
Entity Type:Organization
Organization Name:PWC HOME MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:YONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BELAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-989-7366
Mailing Address - Street 1:12820 MARBLESTONE DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-5387
Mailing Address - Country:US
Mailing Address - Phone:703-989-7366
Mailing Address - Fax:
Practice Address - Street 1:12820 MARBLESTONE DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-5387
Practice Address - Country:US
Practice Address - Phone:703-989-7366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies