Phs Joslin Diabetes Center Dp110

LBN: Phs Providence Diabetes And Nutrition Center
Phs Joslin Diabetes Center Dp110 is an health care organization with primary practice located at 1160 Varnum St Ne Depaul 110, Washington DC 20017-2107. The organization recently has 2 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Dietitian, Registered, Allopathic & Osteopathic Physicians / Surgery. Dietary & Nutritional Service Providers / Dietitian, Registered is the primary health care specialty. Phs Providence Diabetes And Nutrition Center can be contacted via phone (202) 854-7123, or through Higginbotham, Beau via phone (410) 368-3162.

Contact Information

Primary practice address
1160 Varnum St Ne Depaul 110 Washington DC 20017-2107
Phone: (202) 854-7123
Fax: (202) 854-4854
Website:
Map and Directions
Authorized official contact:
Name: Higginbotham, Beau
Phone: (410) 368-3162

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X HFD01-0212 District of Columbia
Allopathic & Osteopathic Physicians / Surgery 208600000X HFD01-0212 District of Columbia

Profile Details

NPI number 1881859817
LBN Legal business name Phs Providence Diabetes And Nutrition Center
DBA Doing business as Phs Joslin Diabetes Center Dp110
Authorized official Higginbotham, Beau
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 18th, 2008
Last updated Oct 9th, 2017 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881859817 NPPES
Maryland MEDICAID 463400400

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