Provider Demographics
NPI:1699734509
Name:UNITED MEDICAL INCORPORATED
Entity type:Organization
Organization Name:UNITED MEDICAL INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:NORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CMF, CF
Authorized Official - Phone:757-363-7746
Mailing Address - Street 1:4654 HAYGOOD RD STE B
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-5448
Mailing Address - Country:US
Mailing Address - Phone:757-363-7746
Mailing Address - Fax:757-363-8225
Practice Address - Street 1:4654 HAYGOOD RD STE B
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-5448
Practice Address - Country:US
Practice Address - Phone:757-363-7746
Practice Address - Fax:757-363-8225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7703088Medicaid
VA1057007OtherCIGNA
VA260745OtherBLUE CROSS
VA009111719Medicaid
MD017100000Medicaid
VA1161OtherGENTIVA
VA1018888OtherACM
VA009111719Medicaid
NC7703088Medicaid