Provider Demographics
NPI:1225769789
Name:MBI HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:MBI HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REVENUE
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-464-9200
Mailing Address - Street 1:4130 HUNT PL NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-3565
Mailing Address - Country:US
Mailing Address - Phone:301-213-2810
Mailing Address - Fax:301-986-1464
Practice Address - Street 1:5140 NANNIE HELEN BURROUGHS AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-5509
Practice Address - Country:US
Practice Address - Phone:202-984-7310
Practice Address - Fax:301-986-1464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service