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NPI Code Detail

MEDICARE: AIR FORCE RETIRED OFFICERS COMMUNITY-WASHINGTON D.C.

MEDICARE: AIR FORCE RETIRED OFFICERS COMMUNITY-WASHINGTON D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing FacilityNH2600VA

General Provider Information

NPI Number : 1477559342
Entity Type Code : Organization
Provider Name (Legal Business Name) : AIR FORCE RETIRED OFFICERS COMMUNITY-WASHINGTON D.C.
Provider Business Mailing Address
First Line : 20535 EARHART PL
Second Line :
City : POTOMAC FALLS
State : VA
Zip : 20165-3581
Country : US
Telephone Number : 703-404-5142
Fax Number :
Provider Business Practice Location Address
First Line : 20535 EARHART PL
Second Line :
City : STERLING
State : VA
Zip : 20165-3581
Country : US
Telephone Number : 703-404-5208
Fax Number :
Authorized Official
Title or Position : CFO
Name : FRED RICHARD BOVA JR.
Credential :
Telephone Number : 703-404-5145
Provider Enumeration Date : 06/24/2005
Last Update Date : 08/08/2024

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Directions to “AIR FORCE RETIRED OFFICERS COMMUNITY-WASHINGTON D.C. ” Practice Location

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