Provider Demographics
NPI:1295049815
Name:EI MEDICAL, INC
Entity type:Organization
Organization Name:EI MEDICAL, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:STEFANIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:HIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-659-3143
Mailing Address - Street 1:9105C OWENS DR
Mailing Address - Street 2:102
Mailing Address - City:MANASSAS PARK
Mailing Address - State:VA
Mailing Address - Zip Code:20111-4833
Mailing Address - Country:US
Mailing Address - Phone:888-271-9583
Mailing Address - Fax:877-644-7937
Practice Address - Street 1:9105C OWENS DR
Practice Address - Street 2:102
Practice Address - City:MANASSAS PARK
Practice Address - State:VA
Practice Address - Zip Code:20111-4833
Practice Address - Country:US
Practice Address - Phone:888-271-9583
Practice Address - Fax:877-644-7937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-06
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6587530001Medicare NSC
VA6587530001Medicare NSC