Organization
IN-HOME MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA STALLWORTH (PRESIDENT)
(703) 768-4440
Entity
Organization
Contact information
Practice address
6911 RICHMOND HWY STE 320, ALEXANDRIA, VA 22306-1846
(703) 768-4440
(703) 768-0923
Mailing address
6911 RICHMOND HWY STE 320, ALEXANDRIA, VA 22306-1846
(703) 768-4440
(703) 768-0923
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0622765
VA
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009114700
—
VA
01
—
1223940001
MEDICARE SUPPLIER DME
VA
01
—
294463
AMERIGROUP PROVIDER NUMBE
VA
Enumeration date
08/19/2006
Last updated
02/14/2025
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