PHS FAMILY MEDICINE & PEDIATRICS PMB103

WASHINGTON, DC
NPI1750659272
Other NamePROVIDENCE HEALTH SERVICES
Entity TypeOrganization
Authorized ContactCHARLES F HABERKERN
VP
202-854-4255
Organization Subpart ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: DC  HFD01-0212)
Additional Taxonomies208000000X Pediatrics
(Licence: DC  HFD01-0212)
282N00000X General Acute Care Hospital
(Licence: DC  HFD01-0212)
Enumeration Date2011-12-12
Last Update Date2016-09-06
Business Address
PHS FAMILY MEDICINE & PEDIATRICS PMB103
1140 VARNUM ST NE PMB103
WASHINGTON, DC 20017-2151
Phone number: 202-854-7074
Mailing Address
PHS FAMILY MEDICINE & PEDIATRICS PMB103
1160 VARNUM ST NE ST CATHERINE'S HALL, ROOM 102
WASHINGTON, DC 20017-2107
Phone number: 202-854-4069