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General NPI Number Information
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NPI Number | 1013865013
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Entity Type | Organization
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Legal Business Name | POTOMAC HOSPITAL CORPORATION OF PRINCE WILLIAM
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Dates
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Enumeration Date | 03/17/2026
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Last Update Date | 03/17/2026
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Provider Practice Location Address
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Address Line | 2300 OPITZ BLVD
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City | WOODBRIDGE
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State | VA
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Zip | 22191-3311
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Country | US
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Telephone | 703-523-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 OPITZ BLVD
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City | WOODBRIDGE
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State | VA
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Zip | 22191-3311
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Country | US
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Telephone | 703-523-1000
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | HELEN TEWOLDE
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Credential |
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Telephone | 334-391-8337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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