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General NPI Number Information
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NPI Number | 1629109806
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Entity Type | Organization
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Legal Business Name | LOUDOUN COMMUNITY HEALTH CENTER
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 163 FORT EVANS ROAD NE
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City | LEESBURG
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State | VA
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Zip | 20176-4420
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Country | US
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Telephone | 703-443-2000
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Fax | 703-443-2033
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Provider Business Mailing Address
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Address Line | 163 FORT EVANS ROAD, NE
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City | LEESBURG
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State | VA
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Zip | 20176-4420
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Country | US
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Telephone | 703-840-4707
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Fax | 703-771-4120
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | AMANDEEP DHINDSA
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Credential | CFO
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Telephone | 703-840-4707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State | VA
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