Organization
MEDICAL HOUSE SUPPLY GROUP
Active
Other names
The Medical House
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLY BENKAHLA (C.E.O)
(703) 533-2290
Entity
Organization
Contact information
Practice address
440 S WASHINGTON ST, FALLS CHURCH, VA 22046-4414
(703) 533-2290
(703) 533-2291
Mailing address
440 S WASHINGTON ST, FALLS CHURCH, VA 22046-4414
(703) 533-2290
(703) 533-2291
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
075758900
DC
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0206009376
VA
332BC3200X
Customized Equipment (DME)
0206009376
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
068395100
—
DC
01
—
075758900
DHCF WAIVER PROGRAM
DC
01
—
1013143791
HEALTHNET FEDERAL SERVICES TRICARE NATIONAL
—
05
—
1013143791
—
VA
01
—
1102778656
GEHA
—
01
—
382202
CIGNA (NATIONAL)
—
01
—
X946
NATIONAL BCBS FEDERAL
—
Enumeration date
06/08/2009
Last updated
08/17/2016
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