Provider Demographics
NPI:1588621833
Name:WASHINGTON HOSPITAL CENTER CORPORATION
Entity Type:Organization
Organization Name:WASHINGTON HOSPITAL CENTER CORPORATION
Other - Org Name:MID ATLANTIC AIR TRANSPORT SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP INTEGRATED OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MATTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-772-6818
Mailing Address - Street 1:PO BOX 418304
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-8304
Mailing Address - Country:US
Mailing Address - Phone:301-552-5730
Mailing Address - Fax:301-306-8587
Practice Address - Street 1:4390 PARLIAMENT PL STE R
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-1865
Practice Address - Country:US
Practice Address - Phone:301-552-5730
Practice Address - Fax:301-306-8587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHFD01-02103416A0800X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD529602100Medicaid
DCW750OtherBCBS-URBAN
DC023410800Medicaid
DC011098759Medicaid
DCW810OtherBCBS- RURAL