Primary Care At Home Professionals | |
4000 Legato Rd Ste 1100 Fairfax VA 22033-2893 | |
(703) 896-7711 | |
(703) 896-7601 |
Full Name | Primary Care At Home Professionals |
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Speciality | Family Medicine |
Location | 4000 Legato Rd Ste 1100, Fairfax, Virginia |
Authorized Official Name and Position | Erica Monique Allen Winslow (OWNER) |
Authorized Official Contact | 7036738223 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Primary Care At Home Professionals 4000 Legato Rd Ste 1100 Fairfax VA 22033-2893 Ph: (703) 896-7711 | Primary Care At Home Professionals 4000 Legato Rd Ste 1100 Fairfax VA 22033-2893 Ph: (703) 896-7711 |
NPI Number | 1508344060 |
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Provider Enumeration Date | 08/06/2018 |
Last Update Date | 08/06/2018 |
Medicare PECOS PAC ID | 2062753254 |
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Medicare Enrollment ID | O20190417000480 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508344060 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 0101252657 (Virginia) | Primary |
Provider Name | Erica Allen-winslow |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1659533800 PECOS PAC ID: 7517289671 Enrollment ID: I20170224000031 |
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