Provider Demographics
NPI:1629132428
Name:WALTER REED ARMY MEDICAL CENTER
Entity Type:Organization
Organization Name:WALTER REED ARMY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARMY SOCIAL WORK OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEARLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:202-782-6378
Mailing Address - Street 1:2J38 WRAMC
Mailing Address - Street 2:6900 GEORGIA AVENUE. NW
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20307-0001
Mailing Address - Country:US
Mailing Address - Phone:202-782-7327
Mailing Address - Fax:
Practice Address - Street 1:2J38 WRAMC
Practice Address - Street 2:6900 GEORGIA AVENUE. NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-0001
Practice Address - Country:US
Practice Address - Phone:202-782-7327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC006216104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty