Provider Demographics
NPI:1952599136
Name:ARMOR MEDICAL
Entity Type:Organization
Organization Name:ARMOR MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:DWANE
Authorized Official - Last Name:STEPHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-401-6329
Mailing Address - Street 1:2724 DORR AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4903
Mailing Address - Country:US
Mailing Address - Phone:703-204-1213
Mailing Address - Fax:703-204-1214
Practice Address - Street 1:2724 DORR AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4903
Practice Address - Country:US
Practice Address - Phone:703-204-1213
Practice Address - Fax:703-204-1214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1952599136Medicaid
VA1952599136Medicaid