1427145176 NPI number — MEDSTAR - GEORGETOWN MEDICAL CENTER, INC.

Table of content: (NPI 1427145176)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427145176 NPI number — MEDSTAR - GEORGETOWN MEDICAL CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDSTAR - GEORGETOWN MEDICAL CENTER, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
GEORGETOWN UNIVERSITY HOSPITAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427145176
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/01/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 15TH ST., N
Provider Second Line Business Mailing Address:
SUITE 401
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22201-2683
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-558-1653
Provider Business Mailing Address Fax Number:
703-558-1650

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3800 RESERVOIR RD., NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20007-2113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-444-3000
Provider Business Practice Location Address Fax Number:
202-444-3095
Provider Enumeration Date:
10/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HO
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
C
Authorized Official Title or Position:
VP OF FINANCE
Authorized Official Telephone Number:
202-444-4724

Provider Taxonomy Codes

  • Taxonomy code: 261QE0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 273R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 009812385 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 950045600 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 028886600 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".




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