# POTOMAC INOVA HEALTHCARE ALLIANCE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Woodbridge CT
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710151402
- **Authorized official:** COLLEEN HUELSKAMP (PROJECT MANAGER)
- **Authorized official phone:** (703) 204-6371

## Contact information

- **Practice address:** 4001 PRINCE WILLIAM PKWY, WOODBRIDGE, VA 22192-7630
- **Practice address phone:** (703) 494-3309
- **Practice address fax:** (703) 357-9636
- **Mailing address:** 2990 TELESTAR CT, SUITE 3PI, FALLS CHURCH, VA 22042-1207
- **Mailing address phone:** (571) 423-5727
- **Mailing address fax:** (571) 423-5702

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/15/2008
- **Last updated:** 11/23/2010