Prime Health | |
1035 Sterling Rd Ste 104 Herndon VA 20170-3838 | |
(703) 840-0610 | |
(571) 323-3243 |
Full Name | Prime Health |
---|---|
Speciality | Clinic/Center |
Location | 1035 Sterling Rd Ste 104, Herndon, Virginia |
Authorized Official Name and Position | Han Tonthat (OFFICER) |
Authorized Official Contact | 7038400610 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Prime Health 1035 Sterling Rd Ste 104 Herndon VA 20170-3838 Ph: (703) 840-0610 | Prime Health 1035 Sterling Rd Ste 104 Herndon VA 20170-3838 Ph: (703) 840-0610 |
NPI Number | 1902067655 |
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Provider Enumeration Date | 06/24/2008 |
Last Update Date | 09/17/2021 |
Medicare PECOS PAC ID | 9931275310 |
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Medicare Enrollment ID | O20080909000305 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902067655 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (Virginia) | Primary |
Provider Name | Han Tonthat |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1801897335 PECOS PAC ID: 3779684345 Enrollment ID: I20070726000330 |
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