Provider Demographics
NPI:1407594286
Name:RESTON HOSPITAL CENTER LLC
Entity Type:Organization
Organization Name:RESTON HOSPITAL CENTER LLC
Other - Org Name:TYSON'S CORNER FSED
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 1:8240 LEESBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2612
Mailing Address - Country:US
Mailing Address - Phone:571-378-8900
Mailing Address - Fax:571-378-8910
Practice Address - Street 1:8240 LEESBURG PIKE
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2612
Practice Address - Country:US
Practice Address - Phone:571-378-8900
Practice Address - Fax:571-378-8910
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESTON HOSPITAL CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care