National Provider Identifier Database

DERRICK J MATHIS, ALFA – NPI #1780822841
Nursing Home Administrator

An individual, often licensed by the state, who is responsible for the management of a nursing home.


Contact Information

DERRICK J MATHIS, ALFA
9827 SUDLEY MANOR DR
MANASSAS, VA20109-6232
Phone: 703-530-7751
Fax:
Website:
Specialty Taxonomy Code
* Nursing Home Administrator 376G00000X

* Indicates primary specialty

NPI Profile & details for DERRICK J MATHIS

NPI Number 1780822841
Credentials ALFA
Entity Individual
Enumeration date 01/28/2009
Last updated 01/28/2009 - About 17 years ago
Sole proprietor1 Yes
Identifiers
  • VA License #: 1706000192
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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