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General NPI Number Information
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NPI Number | 1700061504
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Entity Type | Organization
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Legal Business Name | CAPITOL MEDICAL CENTER LLC
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Dates
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Enumeration Date | 12/31/2007
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Last Update Date | 05/21/2009
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Provider Practice Location Address
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Address Line | 1310 SOUTHERN AVE SE
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City | WASHINGTON
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State | DC
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Zip | 20032-4623
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Country | US
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Telephone | 202-574-6837
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Fax | 202-574-7188
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Provider Business Mailing Address
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Address Line | 1310 SOUTHERN AVE SE
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City | WASHINGTON
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State | DC
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Zip | 20032-4623
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Country | US
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Telephone | 202-574-6837
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Fax | 202-574-7188
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. JOHN MONTOIS
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Credential |
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Telephone | 202-574-6837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | HFDO1-0198
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License Number State | DC
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