Provider Demographics
NPI:1841615572
Name:DIMENSIONS HEALTHCARE ASSOCIATES, INC.
Entity Type:Organization
Organization Name:DIMENSIONS HEALTHCARE ASSOCIATES, INC.
Other - Org Name:SUITLAND FAMILY HEALTH & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:WALLINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-618-3655
Mailing Address - Street 1:3001 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1189
Mailing Address - Country:US
Mailing Address - Phone:301-618-3655
Mailing Address - Fax:301-618-3521
Practice Address - Street 1:5001 SILVER HILL RD
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-5215
Practice Address - Country:US
Practice Address - Phone:301-618-2273
Practice Address - Fax:301-618-3697
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIMENSIONS HEALTHCARE ASSOCIATES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-05
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD405690600Medicaid
MD090782102Medicaid