National Provider Identifier Database

POTOMAC INOVA HEALTHCARE ALLIANCE
Oncology, Radiation


Contact Information

POTOMAC INOVA HEALTHCARE ALLIANCE
2296 OPITZ BLVD
SUITE 140
WOODBRIDGE, VA22191-3300
Phone: 703-670-3349
Fax: 703-580-0730
Website:
Specialty Taxonomy Code
* Oncology, Radiation 261QX0203X

* Indicates primary specialty

NPI Profile & details for POTOMAC INOVA HEALTHCARE ALLIANCE

NPI Number 1013181791
Legal business name
LBN
POTOMAC INOVA HEALTHCARE ALLIANCE
Authorized official JACKIE MASON - (DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 04/15/2008
Last updated 02/26/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers
  • VA Medicaid: 007603118
  • VA Other: 2521782 AETNA HMO
  • VA Other: 7154230 AETNA PPO
  • VA Other: 245110 ANTHEM
  • VA Other: 2108004 MAMSI

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for POTOMAC INOVA HEALTHCARE ALLIANCE

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