Provider Demographics
NPI:1710324363
Name:NEUROTECH, NA INC.
Entity Type:Organization
Organization Name:NEUROTECH, NA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:571-762-1005
Mailing Address - Street 1:11220 ASSETT LOOP
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109
Mailing Address - Country:US
Mailing Address - Phone:571-762-1005
Mailing Address - Fax:571-762-1005
Practice Address - Street 1:11220 ASSETT LOOP
Practice Address - Street 2:SUITE 210
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109
Practice Address - Country:US
Practice Address - Phone:888-980-1197
Practice Address - Fax:888-980-1195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-22
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ269428Medicaid
IN300001916Medicaid
MS03325521Medicaid
VA1710324363Medicaid
MD200143800Medicaid
TX3694762Medicaid
KY7100458560Medicaid
CO9000142686Medicaid
WY145146400Medicaid
NV1710324363Medicaid
IA1710324363Medicaid
SCDM1578Medicaid
GA003185108AMedicaid
PA1032476680001Medicaid
MN1710324363Medicaid
UT3003397Medicaid
MS03325521Medicaid