Provider Demographics
NPI:1396005690
Name:EMERALD HEALTH CENTER
Entity Type:Organization
Organization Name:EMERALD HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAVDENA
Authorized Official - Middle Name:ADAMS
Authorized Official - Last Name:ORR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-723-5326
Mailing Address - Street 1:PO BOX 55744
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20040-5744
Mailing Address - Country:US
Mailing Address - Phone:202-321-6880
Mailing Address - Fax:
Practice Address - Street 1:6323 GEORGIA AVE NW
Practice Address - Street 2:SUITE 210
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1101
Practice Address - Country:US
Practice Address - Phone:202-321-6880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty