Provider Demographics
NPI:1558687897
Name:CAPITAL PALLIAITVE CARE CONSULTANTS, LLC
Entity Type:Organization
Organization Name:CAPITAL PALLIAITVE CARE CONSULTANTS, LLC
Other - Org Name:PALLIATIVE CARE ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:E
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-396-6194
Mailing Address - Street 1:209 GIBSON ST NW
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-2122
Mailing Address - Country:US
Mailing Address - Phone:703-396-6194
Mailing Address - Fax:703-779-1372
Practice Address - Street 1:4401 CONNECTICUT AVE NW
Practice Address - Street 2:700
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2322
Practice Address - Country:US
Practice Address - Phone:703-396-6194
Practice Address - Fax:703-779-1372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-12
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG00802Medicare UPIN
VAC10857Medicare UPIN