Organization
NDIEC MEDICAL SUPPL INC
Active
Other names
NDIEC MEDICAL SUPPL INC, NDI EC MEDICAL & INNOVATION PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ADOLF NDI NGUNDAM RT (PRESIDENT)
(703) 461-3551
Entity
Organization
Contact information
Practice address
6000 STEVENSON AVE, STE A, ALEXANDRIA, VA 22304-3577
(703) 461-3551
(703) 461-3552
Mailing address
6000 STEVENSON AVE, STE A, ALEXANDRIA, VA 22304-3577
(703) 461-3551
(703) 461-3552
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0206009226
VA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2105924
PK
—
Enumeration date
06/20/2006
Last updated
11/14/2019
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