Provider Demographics
NPI:1922320076
Name:PROFESSIONAL HEALTHCARE RESOURCES OF WASHINGTON DC, INC
Entity Type:Organization
Organization Name:PROFESSIONAL HEALTHCARE RESOURCES OF WASHINGTON DC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEMENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-752-8700
Mailing Address - Street 1:7619 LITTLE RIVER TPKE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2625
Mailing Address - Country:US
Mailing Address - Phone:703-752-8700
Mailing Address - Fax:
Practice Address - Street 1:501 SCHOOL ST SW
Practice Address - Street 2:SUITE 200
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-2754
Practice Address - Country:US
Practice Address - Phone:703-752-8700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based