Provider Demographics
NPI:1508273426
Name:VIRGINIA HOSPITAL CENTER PHYSICIAN GROUP LLC
Entity Type:Organization
Organization Name:VIRGINIA HOSPITAL CENTER PHYSICIAN GROUP LLC
Other - Org Name:VIRGINIA HOSPITAL CENTER PHYSICIAN GROUP - PALLIATIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROBI
Authorized Official - Middle Name:
Authorized Official - Last Name:DEPAOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-558-6104
Mailing Address - Street 1:1635 N GEORGE MASON DR
Mailing Address - Street 2:STE 115
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3601
Mailing Address - Country:US
Mailing Address - Phone:703-558-8501
Mailing Address - Fax:703-558-8517
Practice Address - Street 1:1635 N GEORGE MASON DR
Practice Address - Street 2:STE 115
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3601
Practice Address - Country:US
Practice Address - Phone:703-558-8501
Practice Address - Fax:703-558-8517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-14
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LH0002XAllopathic & Osteopathic PhysiciansAnesthesiologyHospice and Palliative MedicineGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty