Provider Demographics
NPI: | 1972730620 |
---|---|
Name: | ASTRIX MEDICAL SUPPLIES |
Entity type: | Organization |
Organization Name: | ASTRIX MEDICAL SUPPLIES |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | F |
Authorized Official - Middle Name: | DAMIEL |
Authorized Official - Last Name: | WRIGHT |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 804-897-4335 |
Mailing Address - Street 1: | 241 E GERMAN SCHOOL RD |
Mailing Address - Street 2: | |
Mailing Address - City: | RICHMOND |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 23224-1460 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 804-897-4335 |
Mailing Address - Fax: | 804-482-2944 |
Practice Address - Street 1: | 241 E GERMAN SCHOOL RD |
Practice Address - Street 2: | |
Practice Address - City: | RICHMOND |
Practice Address - State: | VA |
Practice Address - Zip Code: | 23224-1460 |
Practice Address - Country: | US |
Practice Address - Phone: | 804-897-4335 |
Practice Address - Fax: | 804-482-2944 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-06-19 |
Last Update Date: | 2016-08-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
VA | 6394820001 | Medicare NSC |