NPI 1578979886 KENT VILLAGE MEDICAL CENTER, LLC FAIRFAX VA. Find Phone Number, Address, Contact details of medical healthcare providers | NPI Number Lookup

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Kent Village Medical Center, Llc - NPI: 1578979886

National Provider Identifier (NPI) is a 10-digit identification number which is issued to health care providers by the Centers for Medicare and Medicaid Services (CMS) in the United States(US). The NPI is introduced to replace of UPIN (unique provider identification number) and now NPI is the only required identifier for Medicare services, and NPI is also used by commercial healthcare insurers and by other payers.

Organization Name: KENT VILLAGE MEDICAL CENTER, LLC
NPI Number: 1578979886
Entity Type Code: Organizational (2)
Authorized Official Name: FEDERICO CARLOS GONZALES
(OWNER)
Mailing Address: 112 Kent Village Sq
Manassas Park
State: VA US
Postal Code: 201114155
Phone Number: 7037159700
Fax Number: 7037150202
NPI Enumeration Date: 07/08/2014
NPI Last Update Date: 07/08/2014
Replacement NPI: 0
NPI Deactivation Date:
NPI Reactivation Date:

Taxonomy Information:

Healthcare Provider Taxonomy: 261QU0200X
License Number: 0101028651
Healthcare Provider Taxonomy:
(Secondary)
Y
State: VA
Taxonomy Type: Ambulatory Health Care Facilities
Taxonomy Classification: Clinic/Center
Taxonomy Specialization: Urgent Care
Taxonomy Definition:


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