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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

AMITY HEALTH INC
NPI 1881128544
Pharmacy - Community/Retail Pharmacy in Manassas, VA

Active since April 19, 2017CLIA 49D2198178 · Waiver
9625 SURVEYOR CT STE 100, MANASSAS, VA 20110(571) 357-4818(703) 782-9393 Get Directions Write a Review

NPPES record last updated: October 8, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 8, 2026, Dec 8, 2021, Oct 25, 2019 and 1 more (4 updates tracked since 2017).

About Amity Health Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMITY HEALTH INC (NPI 1881128544), doing business as Bull Run Professional Pharmacy, is a healthcare organization registered as a community/retail pharmacy in Manassas, Virginia and active in the NPI registry since April 2017. The organization holds a CLIA Waiver certificate valid through October 29, 2026 and lists Vasumathi Vantikommu, Pharmacy Owner/manager, as its authorized official.

NPPES Registry Identity

NPI1881128544
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameAMITY HEALTH INC
Location Address9625 SURVEYOR CT STE 100Manassas, VA 20110-4408
Mailing Address42469 Nickens PlAshburn, VA 20148-8064 · (703) 568-2835 · Fax (703) 782-9393
Phone(571) 357-4818
Fax(703) 782-9393
Organization SubpartNo
Authorized OfficialVasumathi VantikommuPharmacy Owner/manager · (703) 568-2835
Enumeration DateApril 19, 2017
Last NPPES UpdateOctober 8, 20264 updates tracked since enumeration
NPPES CertifiedOctober 8, 2026
✔ NPI 1881128544 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in VA · 0201004763
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedPharmacy · Compounding PharmacyTaxonomy 3336C0004X
9625 SURVEYOR CT STE 100, Manassas, VA 20110
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Other Names 1

Doing Business AsBull Run Professional Pharmacy

Other Identifiers 2

Medicaid2017136935VA
Other2168741Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amity Health Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date 2

Next revalidation due by November 30, 2026

This provider holds 2 Medicare enrollments with upcoming revalidation dates. Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateVirginiaEnrollment IDO20211105002649Non-DME Part B · Independent Clinical LaboratoryDue dateNovember 30, 2026
StateVirginiaEnrollment IDO20170908001299DME · PharmacyDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D2198178

Bull Run Professional Pharmacy · Manassas, VA
Active · expires Oct 29, 2026
CLIA Number49D2198178
Laboratory TypePharmacy
Certificate Effective DateOctober 30, 2024
Certificate Expiration DateOctober 29, 2026
Laboratory DirectorVasumathi Vantikommu
Laboratory Phone(571) 357-4818
Laboratory LocationBull Run Professional Pharmacy9210 Church St Suite #100rd, Manassas, VA 20110
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS

Medicare supplier enrollment and the product categories Amity Health Inc carries, from the Medicare DMEPOS supplier directory.

Amity Health Inc

DMEPOS supplier · Manassas, VA
⋮

Does not accept Medicare assignment

Amity Health Inc has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20461619
Medicare Participant SinceMay 12, 2017
Supplier Location9210 Church St Ste 100Manassas, VA 20110
Phone(571) 357-4818
Supplier Specialties
Pharmacy

Medicare Product Categories

Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amity Health Inc's NPI number?

The NPI number for Amity Health Inc is 1881128544. It was assigned to this organization in the NPPES registry on April 19, 2017. The provider is doing business as Bull Run Professional Pharmacy.

Where is Amity Health Inc located?

Amity Health Inc is located at 9625 Surveyor Ct Ste 100, Manassas, VA 20110. The listed phone number is (571) 357-4818.

What is Amity Health Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Is Amity Health Inc enrolled in Medicare?

Yes. Amity Health Inc is registered in the Medicare PECOS enrollment system.

When is Amity Health Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), Amity Health Inc holds 2 Medicare enrollments with upcoming revalidation dates. The next is due by November 30, 2026 (Non-DME Part B, Virginia, Independent Clinical Laboratory). Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Amity Health Inc accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Amity Health Inc does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does Amity Health Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D2198178) is associated with this NPI, valid through October 29, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Amity Health Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 41 other insurers list Amity Health Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Amity Health Inc was last updated on October 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.