Provider Demographics
NPI:1740201532
Name:ADLI BUSINESS & PROFESSIONAL SOLUTIONS, INC.
Entity Type:Organization
Organization Name:ADLI BUSINESS & PROFESSIONAL SOLUTIONS, INC.
Other - Org Name:THE KEY HEALTH CARE DISCOUNT PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:CMR
Authorized Official - Phone:540-587-4003
Mailing Address - Street 1:PO BOX 11431
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24022-1431
Mailing Address - Country:US
Mailing Address - Phone:540-587-4000
Mailing Address - Fax:540-587-6900
Practice Address - Street 1:806 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-2939
Practice Address - Country:US
Practice Address - Phone:540-587-4000
Practice Address - Fax:540-587-6900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336M0002X
VA1101001438332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010278881Medicaid
VA5357200001Medicare ID - Type UnspecifiedPROVIDER IDENTIFICATION