Organization
ICARUS MEDICAL, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID T JOHNSON (CEO)
(434) 242-0258
Entity
Organization
Contact information
Practice address
609 E MARKET ST STE 114, CHARLOTTESVILLE, VA 22902-5305
(434) 242-0258
(434) 270-7278
Mailing address
609 E MARKET ST STE 114, CHARLOTTESVILLE, VA 22902-5305
(888) 492-1101
(434) 270-7278
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
05/18/2020
Last updated
05/01/2024
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