Provider Demographics
NPI:1336324870
Name:AMMAR MEDICAL CENTER. LLC
Entity Type:Organization
Organization Name:AMMAR MEDICAL CENTER. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KHAWAJA
Authorized Official - Middle Name:ATIF
Authorized Official - Last Name:FAROOQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-981-1898
Mailing Address - Street 1:14231 OAKPOINTE DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5865
Mailing Address - Country:US
Mailing Address - Phone:410-662-1535
Mailing Address - Fax:
Practice Address - Street 1:4040 N FAIRFAX DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1811
Practice Address - Country:US
Practice Address - Phone:703-981-1898
Practice Address - Fax:703-564-5618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101242663261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center