Provider Demographics
NPI:1902202161
Name:QMEDICA LLC
Entity Type:Organization
Organization Name:QMEDICA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HANY
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-537-0960
Mailing Address - Street 1:14102 SULLYFIELD CIRCLE
Mailing Address - Street 2:SUITE 150 A
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-1651
Mailing Address - Country:US
Mailing Address - Phone:703-537-0960
Mailing Address - Fax:703-835-9219
Practice Address - Street 1:14102 SULLYFIELD CIRCLE
Practice Address - Street 2:SUITE 150 A
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1651
Practice Address - Country:US
Practice Address - Phone:703-537-0960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-14
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7389610001Medicare NSC