Providence Health Services | |
1160 Varnum St Ne Depaul 021 Washington DC 20017-2107 | |
(202) 854-7785 | |
(202) 854-7734 |
Full Name | Providence Health Services |
---|---|
Speciality | Internal Medicine - Geriatric Medicine |
Location | 1160 Varnum St Ne, Washington, District Of Columbia |
Authorized Official Name and Position | Charles F Haberkern (VP) |
Authorized Official Contact | 2028544255 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Providence Health Services 1160 Varnum St Ne St Catherine's Hall, Room 102 Washington DC 20017-2107 Ph: (202) 854-4069 | Providence Health Services 1160 Varnum St Ne Depaul 021 Washington DC 20017-2107 Ph: (202) 854-7785 |
NPI Number | 1538437926 |
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Provider Enumeration Date | 12/13/2011 |
Last Update Date | 09/06/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538437926 | NPI | - | NPPES |
029833400 | Medicaid | DC | |
09810714 | Medicaid | VA | |
005145400 | Medicaid | MD |
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