1285823542 NPI number — CAPITOL HEALTH MANAGEMENT SERVICES, LLC

Table of content: (NPI 1285823542)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285823542 NPI number — CAPITOL HEALTH MANAGEMENT SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAPITOL HEALTH MANAGEMENT SERVICES, LLC
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:
1285823542
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/04/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4708 BLAGDEN TERRENCE NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20011-3720
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-548-5106
Provider Business Mailing Address Fax Number:
202-548-5180

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1160 VARNUM ST NE
Provider Second Line Business Practice Location Address:
SUITE 317
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20017-2107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-636-1131
Provider Business Practice Location Address Fax Number:
202-636-1138
Provider Enumeration Date:
10/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MCCOY-COLLINS
Authorized Official First Name:
RENEE
Authorized Official Middle Name:
A
Authorized Official Title or Position:
MANAGING MEMBER
Authorized Official Telephone Number:
202-548-5106

Provider Taxonomy Codes

  • Taxonomy code: 133NN1002X , with the licence number:  DEN3652 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: DEN3652 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RC0000X , with the licence number: DEN3652 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RG0100X , with the licence number: DEN3652 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: DEN3652 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RN0300X , with the licence number: DEN3652 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X , with the licence number: DEN3652 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: DEN3652 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207X00000X , with the licence number: DEN3652 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Y00000X , with the licence number: DEN3652 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084N0400X , with the licence number: DEN3652 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: DEN3652 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208800000X , with the licence number: DEN3652 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ES0131X , with the licence number: DEN3652 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: DEN3652 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1194760512 . This is a "NPI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1992746127 . This is a "NPI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1477542306 . This is a "NPI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1306939376 . This is a "NPI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1831259902 . This is a "NPI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1841412319 . This is a "NPI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1033100581 . This is a "NPI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1669458931 . This is a "NPI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1457459778 . This is a "NPI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1487738308 . This is a "NPI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1710064373 . This is a "NPI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1912938408 . This is a "NPI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 039271500 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1073689782 . This is a "NPI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1336135979 . This is a "NPI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1407867146 . This is a "NPI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1801803283 . This is a "NPI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1982718383 . This is a "NPI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1215008982 . This is a "NPI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1992926976 . This is a "NPI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".




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