Organization
PAVILION PACE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GIBSON ERHUNMWUNSE DNP (CEO)
(240) 346-7488
Entity
Organization
Contact information
Practice address
4115 ANNANDALE RD STE 100, ANNANDALE, VA 22003-2583
(240) 346-7488
(703) 226-5604
Mailing address
4115 ANNANDALE RD STE 100, ANNANDALE, VA 22003-2583
(240) 346-7488
(703) 226-5604
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Enumeration date
06/25/2025
Last updated
06/25/2025
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