Provider Demographics
NPI:1689482432
Name:AEGIS MEDICAL LLC
Entity type:Organization
Organization Name:AEGIS MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAMMAD
Authorized Official - Middle Name:KHAN
Authorized Official - Last Name:TATARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-277-9026
Mailing Address - Street 1:218 STEVENSON SQ
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-3510
Mailing Address - Country:US
Mailing Address - Phone:202-277-9026
Mailing Address - Fax:
Practice Address - Street 1:218 STEVENSON SQ
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-3510
Practice Address - Country:US
Practice Address - Phone:202-277-9026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies