Basic Information
| Provider Information | |||||||||
| NPI: | 1962625582 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COLUMBIA CAPITAL MEDICAL CENTER LP | ||||||||
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| OtherOrganizationName: | CAPITAL MEDICAL CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 CORPORATE CENTRE DR | ||||||||
| Address2: | STE. 200 | ||||||||
| City: | FRANKLIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370672659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157643000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3900 CAPITOL MALL DR SW | ||||||||
| Address2: | |||||||||
| City: | OLYMPIA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985028654 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3609562550 | ||||||||
| FaxNumber: | 3609562574 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SLIPKOVICH | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
| AuthorizedOfficialMiddleName: | S. | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6157643000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.