Organization
MEDICAL HOUSE SUPPLY GROUP
Active
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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