EASTERN CRANIAL AFFILIATES, LLC (NPI# 1508954157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508954157 |
| Entity Type | Organization |
| Organization Name | EASTERN CRANIAL AFFILIATES, LLC |
| Other Organization Name | INFINITE TECHNOLOGIES ORTHOTICS & PROSTHETICS |
| Practice Address |
10523 Main St Fairfax VA 22030 |
| Practice Telephone | 7038075899 |
| Practice Fax Number | 7038071183 |
| Mailing Telephone | 7038075899 |
| Mailing Fax Number | 7038071183 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2014-11-18 |
| Authorized Official Name | MR. JOSEPH FRANK TERPENNING (OWNER) |
| Authorized Official Telephone | 7038075899 |
| Authorized Official Credential | C.O., FAAOP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | VA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | ANTHEM | 288615 | 01 |
| VA | BCBS | H933 | 01 |
| VA | 009190121 | 05 |
| Other Name | Type Code |
|---|---|
| Infinite Technologies Orthotics & Prosthetics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437689932 | Eastern Cranial Affiliates, LLC | Clinic/Center | 10523 Main St, Fairfax, VA 22030-3310 | 2017-06-16 |
| 1437525201 | Eastern Cranial Affiliates, LLC | Prosthetic/Orthotic Supplier | 44055 Riverside Pkwy, Suite 106a, Leesburg, VA 20176-5179 | 2015-08-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | EASTERN CRANIAL AFFILIATES, LLC | 3900 N. Fairfax Drive, Suite 100, Arlington, Va 22203 |
| Street Address |
10523 MAIN ST |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437689932 | Eastern Cranial Affiliates, LLC | Clinic/Center | 10523 Main St, Fairfax, VA 22030-3310 | 2017-06-16 |
| 1235596420 | Lacey Rebecca Dungan | Specialist/Technologist | 10523 Main St, Fairfax, VA 22030-3310 | 2016-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205449477 | Perry Camp Jr. | Psychologist | 4403 Dixie Hill Rd, Unit 205, Fairfax, VA 22030 | 2020-08-28 |
| 1952940322 | Brightview Fair Oaks, LLC | Alzheimer Center (Dementia Center) | 12725 Lee Highway, Fairfax, VA 22030 | 2020-01-02 |
| 1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
| 1528612124 | Paul Sarigianis | Student in an Organized Health Care Education/Training Program | 10379b Democracy Lane, Fairfax, VA 22030 | 2019-07-31 |
| 1497221303 | Kahak, Inc. | Day Training, Developmentally Disabled Services | 10560 Main Street Suite Ps100, Fairfax, VA 22030 | 2018-10-17 |
| 1689177073 | Shamoona Sharif | Dentist | 11050 Lee Hwy, Fairfax, VA 22030 | 2018-03-13 |
| 1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1275033607 | Philajo Global LLC | Non-emergency Medical Transport (VAN) | 4521 Billingham Street, Fairfax, VA 22030 | 2018-02-12 |
| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| 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. |
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|---|---|---|---|---|
| 1932718459 | Centers for Advanced Orthopaedics LLC | Durable Medical Equipment & Medical Supplies | 3700 Joseph Siewick Dr Ste 206, Fairfax, VA 22033-1738 | 2020-07-30 |
| 1972074771 | Us Mobility | Durable Medical Equipment & Medical Supplies | 10332 Main St Ste 161, Fairfax, VA 22030-2410 | 2018-12-06 |
| 1083147094 | Rebuilding Together Arlington/fairfax/falls Church | Durable Medical Equipment & Medical Supplies | 10723 Main St # 135, Fairfax, VA 22030-6905 | 2017-04-06 |
| 1770025124 | 1st Adult&pediatric Medical Suppliesllc | Durable Medical Equipment & Medical Supplies | 10650 Main St Ste 102, Fairfax, VA 22030-3814 | 2016-11-15 |
| 1518319508 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 8221 Willow Oaks Corporate Dr Ste 450, Fairfax, VA 22031-4512 | 2016-07-01 |
| 1114391604 | Stone Springs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 10721 Main St Ste 107, Fairfax, VA 22030-6902 | 2015-11-20 |
| 1285007849 | Bravadas of Fairfax LLC | Durable Medical Equipment & Medical Supplies | 11204 Lee Highway, Fairfax, VA 22030 | 2015-11-04 |
| 1568861904 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12734 Shoppes Lane, Fairfax, VA 22033 | 2014-08-21 |
| 1336495753 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2904 District Ave S, Ste 400, Fairfax, VA 22031-2278 | 2012-08-03 |
| 1346511896 | Metro Medical | Durable Medical Equipment & Medical Supplies | 8300 Arlington Blvd, Suite B-1, Fairfax, VA 22031-5217 | 2012-01-14 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.