Provider Demographics
NPI:1265962583
Name:CAPITAL ORTHOPAEDIC SPECIALISTS LLC
Entity type:Organization
Organization Name:CAPITAL ORTHOPAEDIC SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:CAMILLE
Authorized Official - Middle Name:R
Authorized Official - Last Name:BASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-552-8028
Mailing Address - Street 1:PO BOX 418871
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-8871
Mailing Address - Country:US
Mailing Address - Phone:301-599-9500
Mailing Address - Fax:
Practice Address - Street 1:5801 ALLENTOWN RD STE 200
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-4561
Practice Address - Country:US
Practice Address - Phone:301-599-9500
Practice Address - Fax:877-925-7211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-19
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20838261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy