Provider Demographics
NPI:1356482517
Name:WASHINGTON PATHOLOGY SERVICES., INC
Entity Type:Organization
Organization Name:WASHINGTON PATHOLOGY SERVICES., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:T
Authorized Official - Last Name:OCAMPO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-255-5504
Mailing Address - Street 1:200 LAWYERS RD, N.W
Mailing Address - Street 2:#1455
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22183-8071
Mailing Address - Country:US
Mailing Address - Phone:703-255-5504
Mailing Address - Fax:703-255-5507
Practice Address - Street 1:360 MAPLE AVE W
Practice Address - Street 2:SUITE F
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-5614
Practice Address - Country:US
Practice Address - Phone:703-255-5504
Practice Address - Fax:703-255-5507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101030967207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDW431OtherCAREFIRST
1491OtherCAREFIRST
VA201793OtherANTHEM
W1H12OtherEMPIRE BLUE CROSS
B94284Medicare UPIN
W1H12OtherEMPIRE BLUE CROSS