PHS MEDICAL SPECIALISTS PMB107

WASHINGTON, DC
NPI1457693012
Other NamePROVIDENCE HEALTH SERVICES
Entity TypeOrganization
Authorized ContactCHARLES F HABERKERN
VP
202-854-4255
Organization Subpart ?Yes
Primary Taxonomy207RI0200X Internal Medicine, Infectious Disease
(Licence: DC  HFD01-0212)
Additional Taxonomies282N00000X General Acute Care Hospital
(Licence: DC  HFD01-0212)
Enumeration Date2013-03-21
Last Update Date2016-09-06
Business Address
PHS MEDICAL SPECIALISTS PMB107
1140 VARNUM ST NE PMB107
WASHINGTON, DC 20017-2151
Phone number: 202-854-4052
Mailing Address
PHS MEDICAL SPECIALISTS PMB107
1160 VARNUM ST NE ST CATHERINE'S HALL, ROOM 102
WASHINGTON, DC 20017-2107
Phone number: 202-854-4069