Provider Demographics
NPI:1568922813
Name:ARLINGTON MB, LLC
Entity Type:Organization
Organization Name:ARLINGTON MB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVITO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:703-350-5736
Mailing Address - Street 1:22664 AMBERJACK SQ
Mailing Address - Street 2:
Mailing Address - City:BRAMBLETON
Mailing Address - State:VA
Mailing Address - Zip Code:20148-3677
Mailing Address - Country:US
Mailing Address - Phone:703-350-5736
Mailing Address - Fax:
Practice Address - Street 1:2300 9TH ST S
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-2387
Practice Address - Country:US
Practice Address - Phone:703-350-5736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care