Healthcare Provider Details

I. General information

NPI: 1154301240
Provider Name (Legal Business Name): ENDOSCOPY CENTER OF WASHINGTON DC LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 06/28/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 K ST NW SUITE T-115
WASHINGTON DC
20006-1003
US

IV. Provider business mailing address

1A BURTON HILLS BLVD ATTN: L&C
NASHVILLE TN
37215-6103
US

V. Phone/Fax

Practice location:
  • Phone: 202-775-0574
  • Fax: 202-463-1165
Mailing address:
  • Phone: 202-775-0574
  • Fax: 202-463-1165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberHFD060104
License Number StateDC

VIII. Authorized Official

Name: MR. JEFFREY SNODGRASS
Title or Position: PRESIDENT
Credential:
Phone: 615-665-1283