Provider Demographics
NPI:1871810853
Name:DMV MEDICAL, LLC
Entity type:Organization
Organization Name:DMV MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LETTENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-575-8485
Mailing Address - Street 1:5809 MERTON CT
Mailing Address - Street 2:#383
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-5809
Mailing Address - Country:US
Mailing Address - Phone:703-575-8485
Mailing Address - Fax:
Practice Address - Street 1:5809 MERTON CT
Practice Address - Street 2:#383
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-5809
Practice Address - Country:US
Practice Address - Phone:703-575-8485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09-04-17-4056343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)