# PROVIDENCE HEALTH SERVICES, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROVIDENCE HOSPITAL
- **Other names:** PHS Anesthesia
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1740795293
- **Legal business name:** PROVIDENCE HOSPITAL
- **Authorized official:** BEAU HIGGINBOTHAN (VICE PRESIDENT/COO)
- **Authorized official phone:** (410) 368-3182

## Contact information

- **Practice address:** 1150 VARNUM ST NE, WASHINGTON, DC 20017-2104
- **Practice address phone:** (202) 854-4041
- **Practice address fax:** (202) 854-4034
- **Mailing address:** 1150 VARNUM ST NE, ST CATHERINES HALL, ROOM 102, 20017, DC 20017-2104
- **Mailing address phone:** (202) 854-4069
- **Mailing address fax:** (202) 854-7825

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | HFD01-0212 | DC | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | HFD01-0212 | DC | — |
| 367H00000X | Anesthesiologist Assistant | HFD01-0212 | DC | — |

## Other

- **Enumeration date:** 12/06/2017
- **Last updated:** 12/06/2017