Provider Demographics
NPI:1932747706
Name:INERTIA HOLDINGS LLC
Entity Type:Organization
Organization Name:INERTIA HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CANSECO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-490-3729
Mailing Address - Street 1:12800 DARBY BROOK CT
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-8007
Mailing Address - Country:US
Mailing Address - Phone:703-490-3729
Mailing Address - Fax:703-499-9341
Practice Address - Street 1:12800 DARBY BROOK CT
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-8007
Practice Address - Country:US
Practice Address - Phone:703-490-3729
Practice Address - Fax:703-499-9341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care