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BON SECOURS DEPAUL MEDICAL CENTER IMAGE RECOVERY CENTER NPI 1922054287


NPI Information

NPI: 1922054287
Provider Name: BON SECOURS DEPAUL MEDICAL CENTER IMAGE RECOVERY CENTER
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization
Address:
150 KINGSLEY LN
/SUITE #1 - IMAGE RECOVERY CENTER
NORFOLK, VA
ZIP 23505
Phone: (757) 889-5795
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BON SECOURS DEPAUL MEDICAL CENTER IMAGE RECOVERY CENTER is a durable medical equipment medical supplies in Norfolk, VA. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. BON SECOURS DEPAUL MEDICAL CENTER IMAGE RECOVERY CENTER NPI is 1922054287. The provider is registered as an organization entity type.

The provider's business location address is:

150 KINGSLEY LN
/SUITE #1 - IMAGE RECOVERY CENTER
NORFOLK, VA
ZIP 23505-602
Phone: (757) 889-5795
Fax: (757) 889-5820

The provider's authorized official is Daniel Duggan .
The authorized official title is Evp/administrator and has the following contact phone number (757) 889-5851.

The enumeration date for this NPI number is 5/26/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical Supplies1202014479VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
19109404MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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