Provider Demographics
NPI:1326284449
Name:MEDICORP HEALTH SYSTEM
Entity Type:Organization
Organization Name:MEDICORP HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA
Authorized Official - Prefix:
Authorized Official - First Name:AMELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAKELLAROPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-228-4376
Mailing Address - Street 1:15640 THREE OTTERS PL
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20112-5427
Mailing Address - Country:US
Mailing Address - Phone:571-228-4376
Mailing Address - Fax:
Practice Address - Street 1:1001 SAM PERRY BLVD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4453
Practice Address - Country:US
Practice Address - Phone:540-741-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital