Provider Demographics
NPI:1407286289
Name:RESTON HOSPITAL CENTER, LLC
Entity Type:Organization
Organization Name:RESTON HOSPITAL CENTER, LLC
Other - Org Name:STONESPRING EMERGENCY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:EISEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-689-9000
Mailing Address - Street 1:1850 TOWN CENTER PKWY
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3219
Mailing Address - Country:US
Mailing Address - Phone:571-367-4400
Mailing Address - Fax:
Practice Address - Street 1:24570 GUM SPRING RD
Practice Address - Street 2:
Practice Address - City:DULLES
Practice Address - State:VA
Practice Address - Zip Code:20166-2246
Practice Address - Country:US
Practice Address - Phone:571-367-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESTON HOSPITAL CENTER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-15
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care