Provider Demographics
NPI:1740228741
Name:ALLERGY CARE CENTERS OF VIRGINIA INC
Entity Type:Organization
Organization Name:ALLERGY CARE CENTERS OF VIRGINIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMMERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-938-3900
Mailing Address - Street 1:527 MAPLE AVE E
Mailing Address - Street 2:SUITE 300
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4746
Mailing Address - Country:US
Mailing Address - Phone:703-938-3900
Mailing Address - Fax:
Practice Address - Street 1:527 MAPLE AVE E
Practice Address - Street 2:SUITE 300
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4746
Practice Address - Country:US
Practice Address - Phone:703-938-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG01009Medicare ID - Type UnspecifiedGROUP IDENTIFICATION