Basic Information
| Provider Information | |||||||||
| NPI: | 1417509696 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ADVENTIST HEALTHCARE URGENT CARE CENTERS, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 820 W DIAMOND AVE STE 500 | ||||||||
| Address2: | |||||||||
| City: | GAITHERSBURG | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208781469 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3013153102 | ||||||||
| FaxNumber: | 3013096060 | ||||||||
| Practice Location | |||||||||
| Address1: | 7600 CARROLL AVE | ||||||||
| Address2: | |||||||||
| City: | TAKOMA PARK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209126367 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018915079 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2019 | ||||||||
| LastUpdateDate: | 03/22/2021 | ||||||||
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| AuthorizedOfficialLastName: | LEE | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | EVP/CFO | ||||||||
| AuthorizedOfficialTelephone: | 3013153030 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.