Provider Demographics
NPI:1992805022
Name:GOVERNMENT OF THE DISTRICT OF COLUMBIA OFFICE OF TAX AND REVENUE
Entity type:Organization
Organization Name:GOVERNMENT OF THE DISTRICT OF COLUMBIA OFFICE OF TAX AND REVENUE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:BEATON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-727-5225
Mailing Address - Street 1:PO BOX 717767
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19171-7767
Mailing Address - Country:US
Mailing Address - Phone:833-532-2198
Mailing Address - Fax:614-987-2004
Practice Address - Street 1:2000 14TH ST NW
Practice Address - Street 2:SUITE 500
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-4473
Practice Address - Country:US
Practice Address - Phone:202-673-3320
Practice Address - Fax:202-462-0807
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOVERNMENT OF THE DISTRICT OF COLUMBIA OFFICE OF TAX AND REVEN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-25
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCD09728OtherOXFORD HEALTH PLAN
MD402722100Medicaid
DC0061387OtherAETNA
DC080046100OtherFREDERAL BLACK LUNG PROGR
DC117947OtherKAISER PERMANENTE
DC14225OtherSENIOR PARTNERS
DC92423OtherAMERIGROUP
DC140861FYOtherPREFERRED CARE
DCDC0089OtherQUALMED
DCWORKERS COMPENSATIONOtherDEPT OF LABOR
DC801187OtherTUFTS HEALTH PLAN
DC030329900Medicaid
DC590009227OtherRAIL ROAD MCARE UNITED HC
DC100690OtherCHARTERED HEALTH PLAN
DCB920-0001OtherFEDERAL BC CARE FIRST
DCDC0089OtherPHS HEALTH PLAN
DC145098OtherUNISON DPA
DCDC0089OtherHEALTH NET
DC92423OtherAMERIGROUP