Healthcare Provider Details

I. General information

NPI: 1548366404
Provider Name (Legal Business Name): POTOMAC HOSPITAL CORPORATION OF PRINCE WILLIAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 OPITZ BLVD PATIENT FINANCIAL SERVICES
WOODBRIDGE VA
22191-3311
US

IV. Provider business mailing address

2300 OPITZ BLVD PATIENT FINANCIAL SERVICES
WOODBRIDGE VA
22191-3311
US

V. Phone/Fax

Practice location:
  • Phone: 703-670-1595
  • Fax: 703-670-3267
Mailing address:
  • Phone: 703-670-1595
  • Fax: 703-670-3267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberH1771
License Number StateVA

VIII. Authorized Official

Name: MELINDA SUMMERLIN HANCOCK
Title or Position: CFO
Credential:
Phone: 757-455-7458