Healthcare Provider Details

I. General information

NPI: 1740228741
Provider Name (Legal Business Name): ALLERGY CARE CENTERS OF VIRGINIA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 MAPLE AVE E SUITE 300
VIENNA VA
22180-4746
US

IV. Provider business mailing address

527 MAPLE AVE E SUITE 300
VIENNA VA
22180-4746
US

V. Phone/Fax

Practice location:
  • Phone: 703-938-3900
  • Fax:
Mailing address:
  • Phone: 703-938-3900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSIE LAMMERT
Title or Position: BILLING MANAGER
Credential:
Phone: 703-938-3900