Provider Demographics
NPI:1932440856
Name:PALLIATIVE MEDICINE CONSULTANTS OF GREATER WASHINGTON, LLC
Entity Type:Organization
Organization Name:PALLIATIVE MEDICINE CONSULTANTS OF GREATER WASHINGTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-921-4400
Mailing Address - Street 1:1355 PICCARD DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4315
Mailing Address - Country:US
Mailing Address - Phone:301-921-4400
Mailing Address - Fax:301-921-4433
Practice Address - Street 1:9905 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6533
Practice Address - Country:US
Practice Address - Phone:301-921-4400
Practice Address - Fax:301-921-4433
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONTGOMERY HOSPICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG00701Medicare Oscar/Certification