Provider Demographics
NPI:1740822246
Name:ALEXANDRIA MEDICAL CENTER, INC
Entity type:Organization
Organization Name:ALEXANDRIA MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ELEBIARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-705-9500
Mailing Address - Street 1:3606 FOREST DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-1005
Mailing Address - Country:US
Mailing Address - Phone:571-685-2015
Mailing Address - Fax:571-685-2016
Practice Address - Street 1:3606 FOREST DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-1005
Practice Address - Country:US
Practice Address - Phone:571-685-2015
Practice Address - Fax:571-685-2016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center