| Fairfax County Health Department | |
|
10777 Main St Suite 202 Fairfax VA 22030-6903 | |
| (703) 246-8695 | |
| Not Available |
| Full Name | Fairfax County Health Department |
|---|---|
| Speciality | Clinic/Center |
| Location | 10777 Main St, Fairfax, Virginia |
| Authorized Official Name and Position | Anthony Griffin (COUNTY EXECUTIVE) |
| Authorized Official Contact | 7033243360 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairfax County Health Department 12000 Government Center Pkwy Suite 552 Fairfax VA 22035-0001 Ph: (703) 324-3360 | Fairfax County Health Department 10777 Main St Suite 202 Fairfax VA 22030-6903 Ph: (703) 246-8695 |
| NPI Number | 1336171164 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 06/18/2008 |
| Medicare PECOS PAC ID | 9739136847 |
|---|---|
| Medicare Enrollment ID | O20081121000114 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336171164 | NPI | - | NPPES |
| 4970047 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0905X | Clinic/center - Public Health, State Or Local | (Virginia) | Primary |
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