Healthcare Provider Details

I. General information

NPI: 1932146461
Provider Name (Legal Business Name): ADVENTIST HEALTHCARE FORT WASHINGTON MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 04/10/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11711 LIVINGSTON RD
FT WASHINGTON MD
20744-5151
US

IV. Provider business mailing address

11711 LIVINGSTON RD
FT WASHINGTON MD
20744-5151
US

V. Phone/Fax

Practice location:
  • Phone: 301-203-2599
  • Fax: 301-203-7892
Mailing address:
  • Phone: 301-203-2599
  • Fax: 301-203-7892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number16003
License Number StateMD

VIII. Authorized Official

Name: KRISTEN PULIO
Title or Position: SVP/CFO
Credential:
Phone: 301-315-3569