Provider Demographics
NPI:1528151933
Name:METRO CENTRAL MARKET
Entity type:Organization
Organization Name:METRO CENTRAL MARKET
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EUNICE
Authorized Official - Middle Name:
Authorized Official - Last Name:OWUSU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-689-0072
Mailing Address - Street 1:720 GRANT ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4522
Mailing Address - Country:US
Mailing Address - Phone:703-689-0072
Mailing Address - Fax:703-689-0072
Practice Address - Street 1:720 GRANT ST
Practice Address - Street 2:SUITE D
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4522
Practice Address - Country:US
Practice Address - Phone:703-689-0072
Practice Address - Fax:703-689-0072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies