1588621833 NPI number — WASHINGTON HOSPITAL CENTER CORPORATION

Table of content: (NPI 1588621833)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588621833 NPI number — WASHINGTON HOSPITAL CENTER CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WASHINGTON HOSPITAL CENTER CORPORATION
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:
MID ATLANTIC AIR TRANSPORT SERVICE
Provider Other Organization Name Type Code:
3
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:
1588621833
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/12/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 418304
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02241-8304
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-552-5730
Provider Business Mailing Address Fax Number:
301-306-8587

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4390 PARLIAMENT PL STE R
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANHAM
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20706-1865
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-552-5730
Provider Business Practice Location Address Fax Number:
301-306-8587
Provider Enumeration Date:
04/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MATTON
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
SVP INTEGRATED OPERATIONS
Authorized Official Telephone Number:
410-772-6818

Provider Taxonomy Codes

  • Taxonomy code: 3416A0800X , with the licence number:  HFD01-0210 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 529602100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: W750 . This is a "BCBS-URBAN" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 023410800 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 011098759 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: W810 . This is a "BCBS- RURAL" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".




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