Provider Demographics
NPI:1801087549
Name:POTOMAC FESTIVAL URGENT CARE
Entity type:Organization
Organization Name:POTOMAC FESTIVAL URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDHAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-494-2434
Mailing Address - Street 1:14527 JEFFERSON DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-2817
Mailing Address - Country:US
Mailing Address - Phone:703-494-2434
Mailing Address - Fax:703-499-9988
Practice Address - Street 1:14527 JEFFERSON DAVIS HWY
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-2817
Practice Address - Country:US
Practice Address - Phone:703-494-2434
Practice Address - Fax:703-499-9988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty