Organization
SPECIALIZED ORTHOPAEDIC SERVICES,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN (JAY) R KURELICH JR. (PRESIDENT)
(703) 281-1200
Entity
Organization
Contact information
Practice address
307 MAPLE AVE WEST, BUILDING F, VIENNA, VA 22180-4307
(703) 281-1200
(703) 281-1201
Mailing address
307 MAPLE AVE WEST, BUILDING F, VIENNA, VA 22180-4307
(703) 281-1200
(703) 281-1201
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
1114
VA
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010061300
—
VA
01
—
036316600
DC MEDICAID
—
01
—
150078000
DEPT OF LABOR
—
01
—
272601
ANTHEM BCBS
—
01
—
G562
CAREFIRST
—
Enumeration date
08/10/2006
Last updated
05/20/2020
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