Provider Demographics
NPI:1356484851
Name:DEPARTMENT OF HEALTH WAREHOUSE
Entity Type:Organization
Organization Name:DEPARTMENT OF HEALTH WAREHOUSE
Other - Org Name:DISTRICT OF COLUMBIA DEPARTMENT OF HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR DC DEPARTMENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:PANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-442-5954
Mailing Address - Street 1:4 DC VILLAGE LANE SW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-5205
Mailing Address - Country:US
Mailing Address - Phone:202-645-6217
Mailing Address - Fax:202-645-6263
Practice Address - Street 1:4 DC VILLAGE LANE SW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-5205
Practice Address - Country:US
Practice Address - Phone:202-645-6217
Practice Address - Fax:202-645-6263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDW0100023251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare