Provider Demographics
NPI:1063864080
Name:AMBIENT MEDICAL CARE, LLC
Entity Type:Organization
Organization Name:AMBIENT MEDICAL CARE, LLC
Other - Org Name:AMBIENT CARE EXPRESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-603-8457
Mailing Address - Street 1:1000 MIDWAY DR
Mailing Address - Street 2:SUITE 11B
Mailing Address - City:HARRINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19952-2448
Mailing Address - Country:US
Mailing Address - Phone:302-629-3099
Mailing Address - Fax:
Practice Address - Street 1:1000 MIDWAY DR
Practice Address - Street 2:SUITE 11B
Practice Address - City:HARRINGTON
Practice Address - State:DE
Practice Address - Zip Code:19952-2448
Practice Address - Country:US
Practice Address - Phone:302-629-3099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMBIENT MEDICAL CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-07-02
Last Update Date:2016-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2016604668261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care