Organization
JOHN J. BUCHBACH
Active
Other names
East Coast Rehab, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN JACOB BUCHBACH (OWNER)
(703) 370-5790
Entity
Organization
Contact information
Practice address
4944C EISENHOWER AVE, ALEXANDRIA, VA 22304-4809
(703) 370-5790
(703) 370-5793
Mailing address
4944C EISENHOWER AVE, ALEXANDRIA, VA 22304-4809
(703) 370-5790
(703) 370-5793
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
0622638
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009120335
—
VA
Enumeration date
07/11/2006
Last updated
06/24/2008
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