Provider Demographics
NPI:1548653124
Name:HOLY CROSS HEALTH CENTER
Entity type:Organization
Organization Name:HOLY CROSS HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-754-7035
Mailing Address - Street 1:PO BOX 531863
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-1863
Mailing Address - Country:US
Mailing Address - Phone:301-754-8561
Mailing Address - Fax:
Practice Address - Street 1:12800 MIDDLEBROOK RD
Practice Address - Street 2:SUITE 206
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-5204
Practice Address - Country:US
Practice Address - Phone:301-557-1870
Practice Address - Fax:301-557-1879
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOLY CROSS HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-06
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center