Blue Mantle Medicine Pllc

LBN: Blue Mantle Medicine Pllc
Blue Mantle Medicine Pllc is an health care organization with primary practice located at 4001 Fair Ridge Dr Ste 305 , Fairfax VA 22033-2917. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Blue Mantle Medicine Pllc can be contacted via phone (540) 701-4767, or through Canady, Sita via phone (540) 645-1856.

Contact Information

Primary practice address
4001 Fair Ridge Dr Ste 305 Fairfax VA 22033-2917
Phone: (540) 701-4767
Fax: (703) 520-9880
Website:
Map and Directions
Authorized official contact:
Name: Canady, Sita
Phone: (540) 645-1856

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X

Profile Details

NPI number 1417658980
LBN Legal business name Blue Mantle Medicine Pllc
DBA Doing business as
Authorized official Canady, Sita
Entity Organization
Organization subpart 1 No
Enumeration date Mar 13th, 2023
Last updated Mar 13th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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