Organization
PHS CENTER FOR LIFE SC 2ND FLOOR
Active
Parent organization
PROVIDENCE HOSPITAL
Other names
Providence Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HOSPITAL
Authorized official
MR. BEAU HIGGINBOTHAM (VP)
(410) 368-3162
Entity
Organization
Contact information
Practice address
1150 VARNUM ST NE, ST. CATHERINE'S HALL, 2ND FLOOR, WASHINGTON, DC 20017-2107
(202) 269-7074
(202) 372-0026
Mailing address
1150 VARNUM ST NE RM 102, WASHINGTON, DC 20017-2104
(202) 854-7074
(202) 854-7825
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
HFD01-0212
DC
207VG0400X
Gynecology Physician
Primary
HFD01-0212
DC
282N00000X
General Acute Care Hospital
HFD01-0212
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005145400
—
MD
05
—
029833400
—
DC
05
—
09810714
—
VA
Enumeration date
12/12/2011
Last updated
07/21/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us