Healthcare Provider Details

I. General information

NPI: 1144736901
Provider Name (Legal Business Name): LOUDOUN COMMUNITY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2017
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21641 RIDGETOP CIR
STERLING VA
20166-4246
US

IV. Provider business mailing address

163 FORT EVANS RD NE
LEESBURG VA
20176-4420
US

V. Phone/Fax

Practice location:
  • Phone: 703-443-2000
  • Fax:
Mailing address:
  • Phone: 703-443-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROBINE K HARDEY
Title or Position: CFO
Credential:
Phone: 703-443-2000