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General NPI Number Information
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NPI Number | 1013394295
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Entity Type | Organization
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Legal Business Name | BREAST CARE FOR WASHINGTON
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Dates
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Enumeration Date | 04/27/2015
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 4 ATLANTIC ST SW
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City | WASHINGTON
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State | DC
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Zip | 20032-2350
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Country | US
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Telephone | 202-465-7164
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Fax | 202-465-9050
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Provider Business Mailing Address
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Address Line | 4 ATLANTIC ST SW
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City | WASHINGTON
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State | DC
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Zip | 20032-2350
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Country | US
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Telephone | 202-465-7164
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Fax | 202-465-9050
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Authorized Official
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Title or Position | MEDICAL OFFICER
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Name | REGINA HAMPTON
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Credential |
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Telephone | 301-552-7805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0207X
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Taxonomy Name | Mobile Mammography Clinic/Center
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License Number |
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License Number State |
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