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General NPI Number Information
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NPI Number | 1932190626
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Entity Type | Organization
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Legal Business Name | PROVIDENCE HOSPITAL
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 04/03/2019
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Provider Practice Location Address
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Address Line | 1150 VARNUM ST NE
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City | WASHINGTON
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State | DC
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Zip | 20017-2104
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Country | US
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Telephone | 202-854-7000
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Fax | 202-854-7160
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Provider Business Mailing Address
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Address Line | 1150 VARNUM ST NE
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City | WASHINGTON
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State | DC
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Zip | 20017-2104
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Country | US
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Telephone | 202-854-7000
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Fax | 202-854-7160
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Authorized Official
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Title or Position | SR. VP FINANCE/CFO
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Name | MR. SCOTT M FURNISS
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Credential |
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Telephone | 202-854-7147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care 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 | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | HFD01-0212
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License Number State | DC
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