Provider Demographics
NPI:1356704571
Name:HEALTHCARE SERVICES CORPORTATION
Entity type:Organization
Organization Name:HEALTHCARE SERVICES CORPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:240-842-1433
Mailing Address - Street 1:9101 CARRINGTON HILLS CT
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-3429
Mailing Address - Country:US
Mailing Address - Phone:804-823-7707
Mailing Address - Fax:301-291-5033
Practice Address - Street 1:40 ELGIN BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5304
Practice Address - Country:US
Practice Address - Phone:240-382-3554
Practice Address - Fax:301-291-5033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD15200208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD219798Y6FMedicare PIN