Organization · NPI-2

Acsh Primary Care Of Virigina, LLC

Family Medicine · Fairfax, VA

NPI number1902212343
StatusActive
Last updated in NPPESAug 17, 2015

Details

NPI
1902212343
Entity type
Organization (NPI-2)
Legal business name
Acsh Primary Care Of Virigina, LLC
Organization subpart
No
Enumeration date
Jul 7, 2014
Last updated
Aug 17, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Practice location

12713 Shoppes Ln
Fairfax, VA 22033-3834

Phone 703-222-3555

Mailing address

Po Box 101099
Atlanta, GA 30392-1099

Authorized official

Norman Winland
Coo
4044651000

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