Provider Demographics
NPI:1457538191
Name:INOVA ALEXANDRIA HOSPITAL
Entity Type:Organization
Organization Name:INOVA ALEXANDRIA HOSPITAL
Other - Org Name:ALEXANDRIA EKG READERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:RUNYON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-504-3167
Mailing Address - Street 1:2876 GUARDIAN LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7327
Mailing Address - Country:US
Mailing Address - Phone:757-463-5240
Mailing Address - Fax:757-463-6572
Practice Address - Street 1:4320 SEMINARY RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1535
Practice Address - Country:US
Practice Address - Phone:703-504-3236
Practice Address - Fax:757-504-7733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty