Provider Demographics
NPI:1508592114
Name:INOVA UCC LLC
Entity Type:Organization
Organization Name:INOVA UCC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-472-8717
Mailing Address - Street 1:PO BOX 37174
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3174
Mailing Address - Country:US
Mailing Address - Phone:703-289-8655
Mailing Address - Fax:
Practice Address - Street 1:180 MAPLE AVE W
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-5727
Practice Address - Country:US
Practice Address - Phone:571-363-3539
Practice Address - Fax:571-363-3540
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INOVA HEALTHCARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-26
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care