| Great Falls Medical Center, Llc | |
|
1142 Walker Rd Ste C Great Falls VA 22066-1836 | |
| (703) 534-3331 | |
| (703) 534-0704 |
| Full Name | Great Falls Medical Center, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1142 Walker Rd Ste C, Great Falls, Virginia |
| Authorized Official Name and Position | Hieu Van Ho (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7035343331 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Falls Medical Center, Llc 1142 Walker Rd Ste C Great Falls VA 22066-1836 Ph: (703) 534-3331 | Great Falls Medical Center, Llc 1142 Walker Rd Ste C Great Falls VA 22066-1836 Ph: (703) 534-3331 |
| NPI Number | 1689916991 |
|---|---|
| Provider Enumeration Date | 03/25/2013 |
| Last Update Date | 03/25/2013 |
| Medicare PECOS PAC ID | 4486894979 |
|---|---|
| Medicare Enrollment ID | O20130705000042 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689916991 | NPI | - | NPPES |
| 1447479498 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101244972 (Virginia) | Primary |
| Provider Name | Hieu V Ho |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447479498 PECOS PAC ID: 7012157514 Enrollment ID: I20130705000068 |
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