Healthcare Provider Details

I. General information

NPI: 1558687897
Provider Name (Legal Business Name): CAPITAL PALLIAITVE CARE CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2010
Last Update Date: 04/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 CONNECTICUT AVE NW 700
WASHINGTON DC
20008-2322
US

IV. Provider business mailing address

209 GIBSON ST NW
LEESBURG VA
20176-2122
US

V. Phone/Fax

Practice location:
  • Phone: 703-396-6194
  • Fax: 703-779-1372
Mailing address:
  • Phone: 703-396-6194
  • Fax: 703-779-1372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. BARRY E HESS
Title or Position: ADMINISTRATOR
Credential:
Phone: 703-396-6194