Provider Demographics
NPI:1710124060
Name:DEMERARA ACCESS ENTERPRISE
Entity Type:Organization
Organization Name:DEMERARA ACCESS ENTERPRISE
Other - Org Name:AUGCOMM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EARL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BLACKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:ATP
Authorized Official - Phone:804-986-8143
Mailing Address - Street 1:PO BOX 37582
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23234-7582
Mailing Address - Country:US
Mailing Address - Phone:804-986-8143
Mailing Address - Fax:866-394-7926
Practice Address - Street 1:2031 WOODMONT DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-3551
Practice Address - Country:US
Practice Address - Phone:804-986-8143
Practice Address - Fax:866-394-7926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1167194332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment