Provider Demographics
NPI:1487730636
Name:MEDSTAR - GEORGETOWN MEDICAL CENTER, INC.
Entity type:Organization
Organization Name:MEDSTAR - GEORGETOWN MEDICAL CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:WARDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-444-4724
Mailing Address - Street 1:2000 15TH ST., N
Mailing Address - Street 2:SUITE 401
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-2683
Mailing Address - Country:US
Mailing Address - Phone:703-558-1653
Mailing Address - Fax:703-558-1650
Practice Address - Street 1:3800 RESERVOIR RD., NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2113
Practice Address - Country:US
Practice Address - Phone:202-444-3000
Practice Address - Fax:202-444-3095
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDSTAR - GEORGETOWN MEDICAL CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-31
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC09S004Medicare PIN
DC09S004Medicare Oscar/Certification