| Orthovirginia, Inc | |
|
15195 Heathcote Boulevard Suite 334 Haymarket VA 20169-6244 | |
| (703) 369-9070 | |
| (703) 810-5302 |
| Full Name | Orthovirginia, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 15195 Heathcote Boulevard, Haymarket, Virginia |
| Authorized Official Name and Position | Nicole Proffitt (CREDENTIALING AND ENROLLMENT) |
| Authorized Official Contact | 8045332357 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Orthovirginia, Inc Po Box 715868 Philadelphia PA 19171-5868 Ph: (804) 915-1910 | Orthovirginia, Inc 15195 Heathcote Boulevard Suite 334 Haymarket VA 20169-6244 Ph: (703) 369-9070 |
| NPI Number | 1851091722 |
|---|---|
| Provider Enumeration Date | 03/08/2023 |
| Last Update Date | 03/08/2023 |
| Medicare PECOS PAC ID | 0547157224 |
|---|---|
| Medicare Enrollment ID | O20230621001605 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851091722 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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