Provider Demographics
NPI:1316772676
Name:DISTRICT ENDOSCOPY CENTER, LLC
Entity type:Organization
Organization Name:DISTRICT ENDOSCOPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CENTER DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MONAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:919-423-4319
Mailing Address - Street 1:2000 PENNSYLVANIA AVE NW STE 3020
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-1812
Mailing Address - Country:US
Mailing Address - Phone:202-478-4540
Mailing Address - Fax:202-478-4541
Practice Address - Street 1:2000 PENNSYLVANIA AVE NW STE 3020
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1812
Practice Address - Country:US
Practice Address - Phone:202-478-4540
Practice Address - Fax:202-478-4541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical