| Gartlan Csb | |
|
8119 Holland Rd Alexandria VA 22306-3135 | |
| (703) 535-5568 | |
| (703) 299-1794 |
| Full Name | Gartlan Csb |
|---|---|
| Speciality | Clinic/Center |
| Location | 8119 Holland Rd, Alexandria, Virginia |
| Authorized Official Name and Position | Basim Kahn (CEO) |
| Authorized Official Contact | 7035355568 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gartlan Csb Po Box 4320 Glen Allen VA 23058-4320 Ph: (804) 237-7690 | Gartlan Csb 8119 Holland Rd Alexandria VA 22306-3135 Ph: (703) 535-5568 |
| NPI Number | 1669801403 |
|---|---|
| Provider Enumeration Date | 11/02/2013 |
| Last Update Date | 10/10/2014 |
| Medicare PECOS PAC ID | 7517853419 |
|---|---|
| Medicare Enrollment ID | O20140819002092 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669801403 | NPI | - | NPPES |
| 1164620027 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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