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Individual

ROBERT MCCLATCHEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DME PROVIDER

Contact information

Practice address
17865 MAIN ST STE B, DUMFRIES, VA 22026-2411
(703) 763-2687
(800) 584-0815
Mailing address
17865 MAIN ST STE B, DUMFRIES, VA 22026-2411
(540) 288-6828
(800) 584-0815

Taxonomy

Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
0206010050
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0206010050
MEDICAL EQUIPMENT SUPPLIER PERMIT
VA
Enumeration date
04/04/2018
Last updated
04/11/2019
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