1679588156 NPI number — EASTER SEALS GREATER BALTIMORE-WASHINGTON REGION

Table of content: (NPI 1679588156)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679588156 NPI number — EASTER SEALS GREATER BALTIMORE-WASHINGTON REGION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EASTER SEALS GREATER BALTIMORE-WASHINGTON REGION
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:
Provider Other Organization Name Type Code:
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:
1679588156
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/18/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1420 SPRING ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILVER SPRING
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20910-2701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-920-9747
Provider Business Mailing Address Fax Number:
301-576-5317

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2800 13TH ST 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:
20009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-387-4434
Provider Business Practice Location Address Fax Number:
202-467-7379
Provider Enumeration Date:
07/30/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WILSON
Authorized Official First Name:
FRED
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
301-920-9723

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 029979300 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".