MEDICARE: DHC OF WASHINGTON, L.L.C.

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	293D00000X	Physiological Laboratory

General Provider Information

NPI Number	:	1417906876
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DHC OF WASHINGTON, L.L.C.

Provider Business Mailing Address
First Line	:	2764 PELHAM PKWY
Second Line	:
City	:	PELHAM
State	:	AL
Zip	:	35124-1702
Country	:	US
Telephone Number	:	205-685-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 K ST NW
Second Line	:	SUITE 100
City	:	WASHINGTON
State	:	DC
Zip	:	20037-1801
Country	:	US
Telephone Number	:	202-223-5211
Fax Number	:	202-296-6578

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	MRS. SHERI MILLER
Credential	:
Telephone Number	:	205-685-5000

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	01/11/2008

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