Provider Demographics
NPI:1568866549
Name:NOT-FOR-PROFIT HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:NOT-FOR-PROFIT HOSPITAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-574-6611
Mailing Address - Street 1:1310 SOUTHERN AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-4623
Mailing Address - Country:US
Mailing Address - Phone:202-574-6611
Mailing Address - Fax:202-574-7188
Practice Address - Street 1:3720 MARTIN LUTHER KING JR AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-1548
Practice Address - Country:US
Practice Address - Phone:202-574-6611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOT-FOR-PROFIT HOSPITAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHFD01-0198282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC058768300Medicaid
DC058768300Medicaid