Organization
PROVIDENCE HEALTH SERVICES, INC
Active
Organization
PROVIDENCE HEALTH SERVICES, INC
Active
Parent organization
PROVIDENCE HOSPITAL
Other names
PHS Occupational Health/Wellness
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HOSPITAL
Authorized official
BEAU HIGGINBOTHAN (VICE PRESIDENT/COO)
(410) 368-3162
Entity
Organization
Contact information
Practice address
1150 VARNUM ST NE, WASHINGTON, DC 20017-2104
(202) 854-4478
(202) 854-4487
Mailing address
1150 VARNUM ST NE, ST CATHERINES HALL, ROOM 102, WASHINGTON, DC 20017-2104
(202) 854-4069
(202) 854-7825
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
HFD01-0212
DC
Other
Enumeration date
11/17/2017
Last updated
11/17/2017
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