Organization
DOMINION MEDICAL EQUIPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE MOFFETT (ACCOUNT MANAGER)
(703) 263-1325
Entity
Organization
Contact information
Practice address
14100 PARKE LONG CT, SUITE C, CHANTILLY, VA 20151-1644
(703) 263-1325
(703) 263-1805
Mailing address
14100 PARKE LONG CT, SUITE C, CHANTILLY, VA 20151-1644
(703) 263-1325
(703) 263-1805
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/22/2010
Last updated
01/22/2010
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