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HEALTH CONNECT ACO, LLC
>> Internal Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1013358878
Organizational Registrant:Organization Name: HEALTH CONNECT ACO, LLC
Organization is not Subpart
Authorized Official: LAURI RUSTAND PRESIDENT/CEO 703--39-12042
Organization is not Subpart
Authorized Official: LAURI RUSTAND PRESIDENT/CEO 703--39-12042
Location and contact information for practice:
12011 LEE JACKSON HWY SUITE 504 FAIRFAX, VA 22033-3310 US
Tel: 703-391-2042 Fax: --
Tel: 703-391-2042 Fax: --
Contact information for business:
12011 LEE JACKSON HWY SUITE 504 FAIRFAX, VA 22033-3310 US
Tel: 703-391-2042 Fax: --
Tel: 703-391-2042 Fax: --
Registration Information:
NPI: 1013358878
Entity Type: Organization
Entity Type: Organization
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 207R00000X | Allopathic & Osteopathic Physicians Internal Medicine | ||
| Y | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
