# POTOMAC INOVA HEALTHCARE ALLIANCE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Potomac Radiation Oncology Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013181791
- **Authorized official:** MS. JACKIE MASON (DIRECTOR)
- **Authorized official phone:** (703) 670-3349

## Contact information

- **Practice address:** 2296 OPITZ BLVD, SUITE 140, WOODBRIDGE, VA 22191-3300
- **Practice address phone:** (703) 670-3349
- **Practice address fax:** (703) 580-0730
- **Mailing address:** 2990 TELESTAR CT, SUITE 3PI, FALLS CHURCH, VA 22042-1207
- **Mailing address phone:** (571) 423-5727
- **Mailing address fax:** (571) 423-5701

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0203X | Radiation Oncology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/15/2008
- **Last updated:** 02/26/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 007603118 | — | VA |
| 01 | — | 2108004 | MAMSI | VA |
| 01 | — | 245110 | ANTHEM | VA |
| 01 | — | 2521782 | AETNA HMO | VA |
| 01 | — | 7154230 | AETNA PPO | VA |