1346389988 NPI number — GREATER WASHINGTON EMERGENCY PHYSICIANS CHARTERED

Table of content: (NPI 1346389988)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346389988 NPI number — GREATER WASHINGTON EMERGENCY PHYSICIANS CHARTERED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GREATER WASHINGTON EMERGENCY PHYSICIANS CHARTERED
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:
1346389988
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/08/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 500
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARSHALL
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20116-0500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-389-3620
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11711 LIVINGSTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT WASHINGTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20744-5151
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-389-3620
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NARASIMHAN
Authorized Official First Name:
ARVIND
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
202-549-7680

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 079903300 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: CG2248 . This is a "RR MEDICARE" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: H914 . This is a "BLUE SHIELD DC" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: LK41 . This is a "BLUE SHIELD MD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 027064800 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".




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