# PROVIDENCE HEALTH SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROVIDENCE HOSPITAL
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1700040466
- **Legal business name:** PROVIDENCE HOSPITAL
- **Authorized official:** BEAU HIGGINBOTHAM (VICE PRESIDENT/COO)
- **Authorized official phone:** (410) 368-3162

## Contact information

- **Practice address:** 1150 VARNUM ST NE, WASHINGTON, DC 20017-2149
- **Practice address phone:** (202) 269-7000
- **Practice address fax:** (202) 269-7825
- **Mailing address:** 1150 VARNUM ST NE, WASHINGTON, DC 20017-2149
- **Mailing address phone:** (202) 269-7000
- **Mailing address fax:** (202) 269-7825

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | HFD01-0212 | DC | Yes |

## Other

- **Enumeration date:** 07/11/2008
- **Last updated:** 10/10/2017