Provider Demographics
NPI:1841281821
Name:LAWSON MEDICAL LLC
Entity type:Organization
Organization Name:LAWSON MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-631-6311
Mailing Address - Street 1:1821 OLD DONATION PKWY
Mailing Address - Street 2:SUITE 7
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3033
Mailing Address - Country:US
Mailing Address - Phone:757-631-6311
Mailing Address - Fax:757-631-2659
Practice Address - Street 1:1821 OLD DONATION PKWY
Practice Address - Street 2:SUITE 7
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3033
Practice Address - Country:US
Practice Address - Phone:757-631-6311
Practice Address - Fax:757-631-2659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2004165006R332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000023989Medicaid
MD2119348OtherMAMSI/OPTIMUM CH/ALLIANCE
VA605836500OtherACS
NC7703566Medicaid
MD4254OtherELDER HEALTH
VAE2371OtherPRINCE WILLIAM COUNTY SCO
DC0341344 00Medicaid
PA101160020 0001Medicaid
VA1931635OtherCIGNA HEALTHCARE ID NUMBE
VA276746OtherANTHEM BLUE CROSS B/S
VA64178OtherOPTIMA HEALTH CARE
NYG00271OtherEMPIRE BLUE CROSS OF NY
VA009111018Medicaid
MD4032420 00Medicaid
VA1931635OtherCIGNA HEALTHCARE ID NUMBE
DC0341344 00Medicaid
VA4464280001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER