Provider Demographics
NPI:1609641703
Name:SOMO URGENT CARE, INC
Entity Type:Organization
Organization Name:SOMO URGENT CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDYS
Authorized Official - Middle Name:OBEN
Authorized Official - Last Name:EYONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-760-0335
Mailing Address - Street 1:12530 FAIRWOOD PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-6357
Mailing Address - Country:US
Mailing Address - Phone:202-880-9339
Mailing Address - Fax:907-313-1400
Practice Address - Street 1:3010 CRAIN HWY STE 300
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-2838
Practice Address - Country:US
Practice Address - Phone:301-760-0335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-17
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health