1356913446 NPI number — QUICKMED DIAGNOSTIC INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356913446 NPI number — QUICKMED DIAGNOSTIC INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QUICKMED DIAGNOSTIC INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356913446
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/11/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7600 LEESBURG PIKE STE 110
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FALLS CHURCH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22043-2004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
571-534-3973
Provider Business Mailing Address Fax Number:
571-470-8259

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7600 LEESBURG PIKE STE 110
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FALLS CHURCH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22043-2004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
571-534-3973
Provider Business Practice Location Address Fax Number:
571-470-8259
Provider Enumeration Date:
07/16/2021

Additional Information

Authorized Official

Authorized Official Last Name:
SAVVIDES
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
GEORGE
Authorized Official Title or Position:
VP OF OPERATIONS
Authorized Official Telephone Number:
310-905-6441

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 30015305430002 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 49D2231959 . This is a "CLIA ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com