Provider Demographics
NPI:1457533135
Name:CAPITOL MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:CAPITOL MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:F
Authorized Official - Last Name:RIESEBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-546-5700
Mailing Address - Street 1:105 BUSINESS CENTER
Mailing Address - Street 2:155 FLEET STREET
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801
Mailing Address - Country:US
Mailing Address - Phone:202-546-5700
Mailing Address - Fax:202-675-0411
Practice Address - Street 1:1310 SOUTHERN AVENUE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032
Practice Address - Country:US
Practice Address - Phone:202-546-5700
Practice Address - Fax:202-675-0411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282J00000XHospitalsReligious Nonmedical Health Care Institution