Provider Demographics
NPI:1992022511
Name:WASHINGTON HOSPITAL CENTER - PHYSICIAN HOSPITAL ORGANIZATION
Entity Type:Organization
Organization Name:WASHINGTON HOSPITAL CENTER - PHYSICIAN HOSPITAL ORGANIZATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, CONTRACTING
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-933-3075
Mailing Address - Street 1:PO BOX 631300
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21263-1300
Mailing Address - Country:US
Mailing Address - Phone:800-508-6964
Mailing Address - Fax:262-240-2383
Practice Address - Street 1:10201 N PORT WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-5752
Practice Address - Country:US
Practice Address - Phone:800-508-6964
Practice Address - Fax:262-240-2383
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDSTAR HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital