| Healthworks For Northern Virginia | |
|
1141 Elden Street Third Floor Herndon VA 20170-5573 | |
| (703) 481-8160 | |
| (703) 435-6752 |
| Full Name | Healthworks For Northern Virginia |
|---|---|
| Speciality | Clinic/Center |
| Location | 1141 Elden Street, Herndon, Virginia |
| Authorized Official Name and Position | Carol Jameson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7038404704 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthworks For Northern Virginia 163 Fort Evans Rd Ne Leesburg VA 20176-4420 Ph: (703) 840-4707 | Healthworks For Northern Virginia 1141 Elden Street Third Floor Herndon VA 20170-5573 Ph: (703) 481-8160 |
| NPI Number | 1629325758 |
|---|---|
| Provider Enumeration Date | 08/08/2012 |
| Last Update Date | 10/29/2014 |
| Medicare PECOS PAC ID | 5193822930 |
|---|---|
| Medicare Enrollment ID | O20121022000521 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629325758 | NPI | - | NPPES |
| 1629325758 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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