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General NPI Number Information
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NPI Number | 1417922915
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Entity Type | Organization
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Legal Business Name | FRANCONIA-SPRINGFIELD SURGERY CENTER, LLC
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Dates
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Enumeration Date | 02/20/2006
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 6355 WALKER LN SUITE 200
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City | ALEXANDRIA
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State | VA
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Zip | 22310-3245
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Country | US
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Telephone | 703-922-9501
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Fax | 703-922-5347
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Provider Business Mailing Address
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Address Line | 6355 WALKER LN SUITE 200
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City | ALEXANDRIA
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State | VA
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Zip | 22310-3245
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Country | US
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Telephone | 703-922-9501
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Fax | 703-347-7040
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Authorized Official
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Title or Position | AR & OPERATIONS MANAGER
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Name | DARASINH PHOUMMITHONE MAYARD
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Credential |
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Telephone | 703-395-6410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 0H655
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License Number State | VA
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