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NPI Code Detail

MEDICARE: PSI SERVICES III, INC

MEDICARE: PSI SERVICES III, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center0020DC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083828735
Entity Type Code : Organization
Provider Name (Legal Business Name) : PSI SERVICES III, INC
Provider Business Mailing Address
First Line : 8301 PROFESSIONAL PL STE 205
Second Line :
City : HYATTSVILLE
State : MD
Zip : 20785-2353
Country : US
Telephone Number : 301-552-7120
Fax Number :
Provider Business Practice Location Address
First Line : 5820 DIX ST NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20019-6965
Country : US
Telephone Number : 202-547-3870
Fax Number :
Authorized Official
Title or Position : COMMS & IT DIRECTOR
Name : SHAWN RUBBIN
Credential :
Telephone Number : 301-552-7120
Provider Enumeration Date : 05/10/2007
Last Update Date : 08/26/2020

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Directions to “PSI SERVICES III, INC ” Practice Location

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