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Contact Information

PROVIDENCE HEALTH SERVICES
1160 VARNUM ST NE
DEPAUL 104
WASHINGTON, DC20017-2107
 Phone: 202-854-4440
 Fax: 202-854-4430
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for PROVIDENCE HEALTH SERVICES

NPI # 1982868642
LBN Legal business name PROVIDENCE HEALTH SERVICES
Authorized official BEAU HIGGINBOTHAM - (VICE PRESIDENT/COO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 07/11/2008
Last updated 10/09/2017 - About 9 years ago
Identifiers
DC License # HFD01-0212
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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