Provider Demographics
NPI:1316544521
Name:CORDIAL HEALTH CARE CONSORTIUM OF PROVIDERS INC
Entity Type:Organization
Organization Name:CORDIAL HEALTH CARE CONSORTIUM OF PROVIDERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES-OSONDU
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:972-408-8364
Mailing Address - Street 1:9821 GREENBELT RD
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2265
Mailing Address - Country:US
Mailing Address - Phone:301-220-3500
Mailing Address - Fax:301-982-0321
Practice Address - Street 1:9821 GREENBELT RD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2265
Practice Address - Country:US
Practice Address - Phone:301-220-3500
Practice Address - Fax:301-982-0321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty