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Contact Information

PHS BARIATRIC CARE CENTER DP110
1160 VARNUM ST NE
DEPAUL BUILDING SUITE 110
WASHINGTON, DC20017-2107
 Phone: 202-854-4080
 Fax: 202-854-4082
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
 

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
 

General Acute Care Hospital

282N00000X A0[7] Hospital-General
Indicates primary specialty

NPI Profile & details for PHS BARIATRIC CARE CENTER DP110

NPI # 1659649176
LBN Legal business name PHS BARIATRIC CARE CENTER DP110
Authorized official CHARLES HABERKERN - (VP)
Entity Organization
Organization subpart 1 Yes
Enumeration date 12/12/2011
Last updated 09/06/2016 - About 10 years ago
Identifiers
DC License # HFD01-0212
DC Medicaid 029833400
MD Medicaid 005145400
VA Medicaid 09810714
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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