POTOMAC INOVA HEALTHCARE ALLIANCE; NPI #1013181791

Contact Information

POTOMAC INOVA HEALTHCARE ALLIANCE

2296 OPITZ BLVD
SUITE 140
WOODBRIDGE, VA 22191-3300

Phone: 703-670-3349
Fax: 703-580-0730
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Oncology, Radiation	261QX0203X

Indicates primary specialty

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NPI Profile & details for POTOMAC INOVA HEALTHCARE ALLIANCE

NPI # 1013181791

LBN Legal business name POTOMAC INOVA HEALTHCARE ALLIANCE

Authorized official JACKIE MASON - (DIRECTOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 04/15/2008

Last updated 02/26/2013 - About 13 years ago

Identifiers

VA	Medicaid	007603118
VA	Other	2521782	AETNA HMO
VA	Other	7154230	AETNA PPO
VA	Other	245110	ANTHEM
VA	Other	2108004	MAMSI

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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