Organization
INOVA RESTON MRI CENTER LLC
Active
Other names
THE FAIRFAX MRI CENTER AT RESTON
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE POPE (CHIEF FINANCIAL OFFICER)
(703) 289-2048
Entity
Organization
Contact information
Practice address
100 ELDEN ST STE 16M, HERNDON, VA 20170-4873
(703) 481-9400
(703) 481-9408
Mailing address
2722 MERRILEE DR, STE 230, FAIRFAX, VA 22031-4420
(703) 788-8477
(703) 698-2176
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972838993
—
VA
01
—
3120417
UHC
VA
05
—
3810017668
—
WV
01
—
6123294
AETNA HMO
VA
01
—
9616343
AETNA - PPO
VA
Enumeration date
10/15/2009
Last updated
11/02/2022
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