Organization
ADTS, INC.
Active
Other names
Prince William Home Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SYDNEY A. FORTUNE (PRESIDENT)
(703) 361-4211
Entity
Organization
Contact information
Practice address
8724 SUDLEY ROAD, MANASSAS, VA 20110-4405
(703) 361-4211
(703) 361-0028
Mailing address
PO BOX 1070, 5037 HALIFAX ROAD, HALIFAX, VA 24558-3185
(434) 572-1682
(434) 572-1682
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
0206008374
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009119434
—
VA
01
—
235085
BCBS
VA
01
—
295749
AMERIGROUP
—
Enumeration date
06/03/2006
Last updated
10/31/2008
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