1245328566 NPI number — SLEEP CENTERS OF NORTHERN VIRGINIA

Table of content: MISS INDIA RACHELLE JACKSON (NPI 1689978470)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245328566 NPI number — SLEEP CENTERS OF NORTHERN VIRGINIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SLEEP CENTERS OF NORTHERN VIRGINIA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245328566
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6610
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALEXANDRIA
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22306
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8101 HINSON FARM ROAD
Provider Second Line Business Practice Location Address:
SUITE #204
Provider Business Practice Location Address City Name:
ALEXANDRIA
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-780-2925
Provider Business Practice Location Address Fax Number:
866-327-4800
Provider Enumeration Date:
10/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HOFFMAN
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
ALAN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
703-780-2925

Provider Taxonomy Codes

  • Taxonomy code: 261QS1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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