Healthcare Provider Details

I. General information

NPI: 1629132428
Provider Name (Legal Business Name): WALTER REED ARMY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2J38 WRAMC 6900 GEORGIA AVENUE. NW
WASHINGTON DC
20307-0001
US

IV. Provider business mailing address

2J38 WRAMC 6900 GEORGIA AVENUE. NW
WASHINGTON DC
20307-0001
US

V. Phone/Fax

Practice location:
  • Phone: 202-782-7327
  • Fax:
Mailing address:
  • Phone: 202-782-7327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number006216
License Number StateSC

VIII. Authorized Official

Name: MRS. PEARLIE HODGES
Title or Position: ARMY SOCIAL WORK OFFICER
Credential: LMSW
Phone: 202-782-6378