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Organization
CNMC CLINIC AT BALLOU HS
Active
Organization
CNMC CLINIC AT BALLOU HS
Active
Parent organization
CHILDREN'S HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN'S HOSPITAL
Authorized official
MS. SUSAN M. PFENNIG (SENIOR MANAGER)
(202) 476-4447
Entity
Organization
Contact information
Practice address
3401 4TH ST SE, WASHINGTON, DC 20032-5406
(202) 476-4447
Mailing address
PO BOX 37215, BALTIMORE, MD 21297-3215
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
NULL
261QS1000X
Student Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
01/10/2017
Last updated
12/18/2017
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