Provider Demographics
NPI:1427145176
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:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:HO
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?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
No273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009812385Medicaid
MD950045600Medicaid
DC028886600Medicaid
DC092302Medicare Oscar/Certification
DC028886600Medicaid
DC090004Medicare PIN