Provider Demographics
NPI:1235721556
Name:CLARKSBURG URGENT CARE LLC
Entity Type:Organization
Organization Name:CLARKSBURG URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WORNYO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-919-9051
Mailing Address - Street 1:22750 NEWCUT RD STE D1B
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-5333
Mailing Address - Country:US
Mailing Address - Phone:301-302-8513
Mailing Address - Fax:301-302-8514
Practice Address - Street 1:22750 NEWCUT RD STE D1B
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:MD
Practice Address - Zip Code:20871-5333
Practice Address - Country:US
Practice Address - Phone:301-302-8513
Practice Address - Fax:301-302-8514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care