Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pavilion Pace, LLC

Organization PACE Provider Organization · NPI 1164310496

Pavilion Pace, LLC is a PACE Provider Organization in Annandale, Virginia. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

4115 Annandale Rd Ste 100
Annandale, VA 22003-2583
Phone: (240) 346-7488
Fax: (703) 226-5604
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

PACE Provider Organization (primary) Taxonomy 251T00000X

Record details

NPI number1164310496
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gibson Erhunmwunse — Ceo · (240) 346-7488
NPI enumeratedJune 25, 2025
Last updated in NPPESJune 25, 2025
Certification dateJune 25, 2025
Mailing address4115 Annandale Rd Ste 100, Annandale, VA 22003-2583