Provider Demographics
NPI:1437881000
Name:COLUMBIA JOINT HEALTH LLC
Entity Type:Organization
Organization Name:COLUMBIA JOINT HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DEREJE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-575-3998
Mailing Address - Street 1:3313 CASTLE RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7343
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7130 MINSTREL WAY STE 210
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5265
Practice Address - Country:US
Practice Address - Phone:410-575-3998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-30
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty