Provider Demographics
NPI:1417568999
Name:INTEGRATED HEALTH CENTER OF ARLINGTON
Entity Type:Organization
Organization Name:INTEGRATED HEALTH CENTER OF ARLINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:AJITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RATNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-438-8419
Mailing Address - Street 1:46 S GLEBE RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-1655
Mailing Address - Country:US
Mailing Address - Phone:703-915-8921
Mailing Address - Fax:
Practice Address - Street 1:46 S GLEBE RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-1655
Practice Address - Country:US
Practice Address - Phone:703-915-8921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty