Healthcare Provider Details

I. General information

NPI: 1376095083
Provider Name (Legal Business Name): METRO HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2016
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 PENNSYLVANIA AVE SE STE LL1
WASHINGTON DC
20003-6414
US

IV. Provider business mailing address

600 PENNSYLVANIA AVE SE STE LL1
WASHINGTON DC
20003-6414
US

V. Phone/Fax

Practice location:
  • Phone: 771-245-2140
  • Fax:
Mailing address:
  • Phone: 771-245-2140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: VINCENT JOSEPH LOPEZ
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 771-245-2140