Provider Demographics
NPI:1073771119
Name:HMS MEDICAL GROUP I PA
Entity Type:Organization
Organization Name:HMS MEDICAL GROUP I PA
Other - Org Name:HMS MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-565-2250
Mailing Address - Street 1:PO BOX 418462
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-8462
Mailing Address - Country:US
Mailing Address - Phone:301-565-2250
Mailing Address - Fax:301-565-2159
Practice Address - Street 1:10801 LOCKWOOD DR STE 205
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1563
Practice Address - Country:US
Practice Address - Phone:301-593-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG01533Medicare PIN