Individual ProviderMari DugassaInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address3300 Gallows Rd, Falls Church, VA 22042-3307(703) 776-4001PECOS EnrollmentBased on the most recent information from CMS, provider Mari Dugassa is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1295140127Provider TypeIndividualFull NameDugassa, MariGenderFemaleSole ProprietorYesEnumeration Date6/30/2014Last Updated1/20/2023Contact InformationPractice LocationPractice Address3300 Gallows Rd, Falls Church, VA 22042-3307Phone(703) 776-4001Fax(703) 776-7113Mailing LocationMailing Address3300 Gallows Rd, Falls Church, VA 22042-3307Phone(703) 776-4001Fax(703) 776-7113Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense0101267053VirginiaCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense78163Georgia