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General NPI Number Information
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NPI Number | 1184178550
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Entity Type | Organization
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Legal Business Name | INOVA HEALTH SYSTEM SERVICES
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Dates
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Enumeration Date | 08/15/2016
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Last Update Date | 08/15/2016
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Provider Practice Location Address
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Address Line | 21785 FILIGREE CT SUITE 100
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City | ASHBURN
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State | VA
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Zip | 20147-6213
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Country | US
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Telephone | 703-554-1111
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Fax | 703-554-1101
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Provider Business Mailing Address
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Address Line | 21785 FILIGREE CT SUITE 100
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City | ASHBURN
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State | VA
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Zip | 20147-6213
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Country | US
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Telephone | 703-554-1111
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Fax | 703-554-1101
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Authorized Official
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Title or Position | SR. DIRECTOR, PHYSICIAN OUTPATIENT
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Name | MRS. STEPHANIE W APPLING
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Credential | MPH
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Telephone | 571-581-3322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 0024173760
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License Number State | VA
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