Provider Demographics
NPI:1487385720
Name:POOL OF BETHESDA CHILDREN AND ADULT HOSPITAL
Entity type:Organization
Organization Name:POOL OF BETHESDA CHILDREN AND ADULT HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:VIOLA
Authorized Official - Last Name:MONTILINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-642-8316
Mailing Address - Street 1:3761 S NORMANDIE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90007-4256
Mailing Address - Country:US
Mailing Address - Phone:310-642-8316
Mailing Address - Fax:
Practice Address - Street 1:3761 S NORMANDIE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90007-4256
Practice Address - Country:US
Practice Address - Phone:310-642-8316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital
No251V00000XAgenciesVoluntary or Charitable
No261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch
No291U00000XLaboratoriesClinical Medical Laboratory
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility