Healthcare Provider Details

I. General information

NPI: 1396005690
Provider Name (Legal Business Name): EMERALD HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2012
Last Update Date: 05/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6323 GEORGIA AVE NW SUITE 210
WASHINGTON DC
20011-1101
US

IV. Provider business mailing address

PO BOX 55744
WASHINGTON DC
20040-5744
US

V. Phone/Fax

Practice location:
  • Phone: 202-321-6880
  • Fax:
Mailing address:
  • Phone: 202-321-6880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LAVDENA ADAMS ORR
Title or Position: OWNER
Credential: MD
Phone: 202-723-5326