Organization
BLUE SANDCASTLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INGRID MARIE WISVEY (AUTHORIZED OFFICIAL)
(469) 915-5044
Entity
Organization
Contact information
Practice address
215 N PAYNE ST STE 94521, ALEXANDRIA, VA 22314-2444
(469) 915-5044
Mailing address
215 N PAYNE ST STE 94521, ALEXANDRIA, VA 22314-2444
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/20/2026
Last updated
02/20/2026
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