Provider Demographics
NPI:1659743995
Name:ALLCARE VA INC
Entity Type:Organization
Organization Name:ALLCARE VA INC
Other - Org Name:FAMILY CARE OF LAKE RIDGE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEVORG
Authorized Official - Middle Name:
Authorized Official - Last Name:SEDRAKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-393-3653
Mailing Address - Street 1:4167 MERCHANT PLZ
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-5088
Mailing Address - Country:US
Mailing Address - Phone:703-878-8800
Mailing Address - Fax:540-242-0933
Practice Address - Street 1:4167 MERCHANT PLZ
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-5088
Practice Address - Country:US
Practice Address - Phone:703-878-8800
Practice Address - Fax:540-242-0933
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAPITAL HEALTHCARE PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-27
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty