1366602047 NPI number — HEALING HANDS PHYSICAL THERAPY SERVICES

Table of content: (NPI 1366602047)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366602047 NPI number — HEALING HANDS PHYSICAL THERAPY SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALING HANDS PHYSICAL THERAPY SERVICES
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:
1366602047
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/20/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6323 GEORGIA AVE NW
Provider Second Line Business Mailing Address:
# 350 B
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20011-1101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-545-8444
Provider Business Mailing Address Fax Number:
202-545-8446

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6323 GEORGIA AVE NW
Provider Second Line Business Practice Location Address:
# 350 B
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20011-1101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-545-8444
Provider Business Practice Location Address Fax Number:
202-545-8446
Provider Enumeration Date:
06/16/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MARSH
Authorized Official First Name:
MARVA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
202-545-8444

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT1076 , 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)

  • Identifier: 328752 . This is a "UNITED HEALTHCARE (MAMSI, ALLIANCE PPO, MD IPA)" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 650011408 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1258184 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: S4740001 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 147057500 . This is a "DEPARTMENT OF LABOR" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".




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