Organization
MEDCO
Active
Organization
MEDCO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNETTE FLEMING MCCLATCHEY CEO (PRESIDENT)
(703) 490-8106
Entity
Organization
Contact information
Practice address
14470 SMOKETOWN RD, WOODBRIDGE, VA 22192-4712
(703) 490-5980
(703) 490-8107
Mailing address
14470 SMOKETOWN RD, WOODBRIDGE, VA 22192-4712
(703) 490-5980
(703) 490-8107
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0206009192
VA
Other
Enumeration date
11/09/2006
Last updated
08/22/2020
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