Provider Demographics
NPI:1952523813
Name:BETHESDA HEALTH CENTER LLC
Entity type:Organization
Organization Name:BETHESDA HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER - OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERNESTINE
Authorized Official - Middle Name:HAMENI
Authorized Official - Last Name:LENTEU
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:301-951-1050
Mailing Address - Street 1:8218 WISCONSIN AVE
Mailing Address - Street 2:SUITE 311
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814
Mailing Address - Country:US
Mailing Address - Phone:301-951-1050
Mailing Address - Fax:301-718-2563
Practice Address - Street 1:8218 WISCONSIN AVE
Practice Address - Street 2:SUITE 311
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814
Practice Address - Country:US
Practice Address - Phone:301-951-1050
Practice Address - Fax:301-718-2563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD23135207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty