Provider Demographics
NPI:1477129914
Name:VIRGINIA HOSPITAL CENTER ARLINGTON HEALTH SYSTEM
Entity Type:Organization
Organization Name:VIRGINIA HOSPITAL CENTER ARLINGTON HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:TIPPACHONE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIRIDAVONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-558-5500
Mailing Address - Street 1:1715 N GEORGE MASON DR STE 105
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3640
Mailing Address - Country:US
Mailing Address - Phone:703-558-5718
Mailing Address - Fax:703-558-2455
Practice Address - Street 1:1701 N GEORGE MASON DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3610
Practice Address - Country:US
Practice Address - Phone:703-558-5718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIRGINIA HOSPITAL CENTER ARLINGTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-03
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty