Healthcare Provider Details

I. General information

NPI: 1588621833
Provider Name (Legal Business Name): WASHINGTON HOSPITAL CENTER CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 01/12/2022
Certification Date: 01/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4390 PARLIAMENT PL STE R
LANHAM MD
20706-1865
US

IV. Provider business mailing address

PO BOX 418304
BOSTON MA
02241-8304
US

V. Phone/Fax

Practice location:
  • Phone: 301-552-5730
  • Fax: 301-306-8587
Mailing address:
  • Phone: 301-552-5730
  • Fax: 301-306-8587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License NumberHFD01-0210
License Number StateDC

VIII. Authorized Official

Name: JEFFREY A MATTON
Title or Position: SVP INTEGRATED OPERATIONS
Credential:
Phone: 410-772-6818