MEDICARE: THE WASHINGTON HOME

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
1	251G00000X	Community Based Hospice Care Agency	058915	VA

Other Identifiers

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

General Provider Information

NPI Number	:	1386635209
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE WASHINGTON HOME

Provider Business Mailing Address
First Line	:	3720 UPTON ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20016-2299
Country	:	US
Telephone Number	:	202-895-0192
Fax Number	:	202-895-0190

Provider Business Practice Location Address
First Line	:	520 N WASHINGTON ST
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22046-3538
Country	:	US
Telephone Number	:	202-895-0192
Fax Number	:	202-895-0190

Authorized Official
Title or Position	:	DIRECTOR OF HOSPICE OPERATION
Name	:	MS. BEVERLY PAUKSTIS
Credential	:
Telephone Number	:	202-895-0117

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	02/03/2010

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Directions to “THE WASHINGTON HOME ” Practice Location

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