Provider Demographics
NPI:1962058214
Name:SAINT ELIZABETHS HOSPITAL
Entity type:Organization
Organization Name:SAINT ELIZABETHS HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ATTENDING DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:202-299-5100
Mailing Address - Street 1:1349 KENYON ST NW APT 44
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2346
Mailing Address - Country:US
Mailing Address - Phone:240-547-8653
Mailing Address - Fax:
Practice Address - Street 1:1100 ALABAMA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4542
Practice Address - Country:US
Practice Address - Phone:202-299-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-13
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Multi-Specialty