1063684330 NPI number — WASHINGTON HOSPITAL CENTER CORP

Table of content: (NPI 1063684330)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063684330 NPI number — WASHINGTON HOSPITAL CENTER CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WASHINGTON HOSPITAL CENTER CORP
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:
WASHINGTON HOSPITAL CENTER PHYSICIANS
Provider Other Organization Name Type Code:
5
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:
1063684330
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/13/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6525 BELCREST RD.
Provider Second Line Business Mailing Address:
STE 320 WHC-PBS
Provider Business Mailing Address City Name:
HYATTSVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20782-2022
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-209-5612
Provider Business Mailing Address Fax Number:
301-209-5656

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 HOSPITAL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRINCE FREDERICK
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20678-4017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-855-1012
Provider Business Practice Location Address Fax Number:
301-209-5656
Provider Enumeration Date:
03/27/2008

Additional Information

Authorized Official

Authorized Official Last Name:
ORLOWSKI
Authorized Official First Name:
JANIS
Authorized Official Middle Name:
M
Authorized Official Title or Position:
SNR VICE PRES. AND CHIEF MED. OFF.
Authorized Official Telephone Number:
202-877-5284

Provider Taxonomy Codes

  • Taxonomy code: 2086S0129X , with the licence number:  HFD01-0210 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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