MEDICARE: DISTRICT ENDOSCOPY CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1316772676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DISTRICT ENDOSCOPY CENTER, LLC

Provider Business Mailing Address
First Line	:	2000 PENNSYLVANIA AVE NW STE 3020
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20006-1812
Country	:	US
Telephone Number	:	202-478-4540
Fax Number	:	202-478-4541

Provider Business Practice Location Address
First Line	:	2000 PENNSYLVANIA AVE NW STE 3020
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20006-1812
Country	:	US
Telephone Number	:	202-478-4540
Fax Number	:	202-478-4541

Authorized Official
Title or Position	:	CENTER DIRECTOR
Name	:	MS. JACQUELINE J MONAHAN
Credential	:	RN
Telephone Number	:	919-423-4319

Provider Enumeration Date	:	09/05/2024
Last Update Date	:	09/05/2024

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Directions to “DISTRICT ENDOSCOPY CENTER, LLC ” Practice Location

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