Provider Demographics
NPI:1407046642
Name:CAPITAL HOSPICE
Entity Type:Organization
Organization Name:CAPITAL HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHWIND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-531-1108
Mailing Address - Street 1:2900 TELESTAR CT
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1206
Mailing Address - Country:US
Mailing Address - Phone:703-538-2065
Mailing Address - Fax:703-532-1054
Practice Address - Street 1:9200 BASIL CT
Practice Address - Street 2:SUITE 200
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5309
Practice Address - Country:US
Practice Address - Phone:301-883-0865
Practice Address - Fax:301-883-0925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD400403500Medicaid