Healthcare Provider Details

I. General information

NPI: 1952334450
Provider Name (Legal Business Name): DIRECTOR OF FINANCE-COUNTY OF FAIRFAX VA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 10/30/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 BLENHEIM BLVD
FAIRFAX VA
22030-1806
US

IV. Provider business mailing address

12000 GOVERNMENT CENTER PKWY SUITE 552
FAIRFAX VA
22035-0001
US

V. Phone/Fax

Practice location:
  • Phone: 703-246-7121
  • Fax: 703-653-1385
Mailing address:
  • Phone: 703-324-3360
  • Fax: 703-324-4573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number113
License Number StateVA

VIII. Authorized Official

Name: BRYAN J HILL
Title or Position: COUNTY EXECUTIVE
Credential:
Phone: 703-324-2536