Provider Demographics
NPI:1417922915
Name:FRANCONIA-SPRINGFIELD SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:FRANCONIA-SPRINGFIELD SURGERY CENTER, LLC
Other - Org Name:INOVA SURGERY CENTER @ FRANCONIA-SPRINGFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AR & OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DARASINH
Authorized Official - Middle Name:PHOUMMITHONE
Authorized Official - Last Name:MAYARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-395-6410
Mailing Address - Street 1:6355 WALKER LN
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-3245
Mailing Address - Country:US
Mailing Address - Phone:703-922-9501
Mailing Address - Fax:703-347-7040
Practice Address - Street 1:6355 WALKER LN
Practice Address - Street 2:SUITE 200
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3245
Practice Address - Country:US
Practice Address - Phone:703-922-9501
Practice Address - Fax:703-922-5347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-20
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0H655261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7600445Medicaid
VAA00034Medicare PIN