1659563799 NPI number — CAPITAL DIGESTIVE CARE LLC

Table of content: (NPI 1659563799)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659563799 NPI number — CAPITAL DIGESTIVE CARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAPITAL DIGESTIVE CARE 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:
6
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:
1659563799
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10770 COLUMBIA PIKE STE 400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILVER SPRING
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20901-4462
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-485-5210
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
885 KEMPSVILLE RD
Provider Second Line Business Practice Location Address:
SUITE 114
Provider Business Practice Location Address City Name:
NORFOLK
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23502-3800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-466-0165
Provider Business Practice Location Address Fax Number:
757-466-7296
Provider Enumeration Date:
08/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NEUMANN
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT & CHIEF STRATEGY OFFICER
Authorized Official Telephone Number:
757-483-6100

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com