Provider Demographics
NPI:1891127957
Name:PAIN CONNECTION - CHRONIC PAIN OUTREACH CENER, INC.
Entity Type:Organization
Organization Name:PAIN CONNECTION - CHRONIC PAIN OUTREACH CENER, INC.
Other - Org Name:PAIN CONNECTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOARD DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-231-0008
Mailing Address - Street 1:12320 PARKLAWN DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1726
Mailing Address - Country:US
Mailing Address - Phone:301-231-0008
Mailing Address - Fax:301-231-6668
Practice Address - Street 1:12320 PARKLAWN DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1726
Practice Address - Country:US
Practice Address - Phone:301-231-0008
Practice Address - Fax:301-231-6668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable