=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528275732
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FALLS CHURCH MEDICAL CENTER LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/17/2007
-----------------------------------------------------
Last Update Date | 08/01/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 900 S WASHINGTON ST SUITE 300
-----------------------------------------------------
City | FALLS CHURCH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22046-4020
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-532-2500
-----------------------------------------------------
Fax | 703-237-1184
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 900 S WASHINGTON ST SUITE 300
-----------------------------------------------------
City | FALLS CHURCH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22046-4020
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-532-2500
-----------------------------------------------------
Fax | 703-237-1184
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | POLICY DIRECTOR
-----------------------------------------------------
Name | MRS. ROSEMARY WILBUR CODDING
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 703-532-2500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174H00000X
-----------------------------------------------------
Taxonomy Name | Health Educator
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 367500000X
-----------------------------------------------------
Taxonomy Name | Certified Registered Nurse Anesthetist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------