| Health Connect Aco, LLC | |
|
12011 Lee Jackson Hwy Suite 504 Fairfax VA 22033-3310 | |
| (703) 391-2042 | |
| Not Available |
| Full Name | Health Connect Aco, LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 12011 Lee Jackson Hwy, Fairfax, Virginia |
| Authorized Official Name and Position | Lauri Rustand (PRESIDENT/CEO) |
| Authorized Official Contact | 7033912042 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Connect Aco, LLC 12011 Lee Jackson Hwy Suite 504 Fairfax VA 22033-3310 Ph: (703) 391-2042 | Health Connect Aco, LLC 12011 Lee Jackson Hwy Suite 504 Fairfax VA 22033-3310 Ph: (703) 391-2042 |
| NPI Number | 1013358878 |
|---|---|
| Provider Enumeration Date | 07/09/2013 |
| Last Update Date | 07/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013358878 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| 207R00000X | Internal Medicine | (NU) | Secondary |
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