Provider Demographics
NPI:1659793891
Name:INOVA AMBULATORY SURGERY CENTER AT LORTON, LLC
Entity Type:Organization
Organization Name:INOVA AMBULATORY SURGERY CENTER AT LORTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT AMBULATORY SURGERY
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTUR
Authorized Official - Middle Name:
Authorized Official - Last Name:SIVASLIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-922-5345
Mailing Address - Street 1:9321 SANGER ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-2720
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9321 SANGER ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-2720
Practice Address - Country:US
Practice Address - Phone:703-922-7631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical