Provider Demographics
NPI:1619321981
Name:ADVENTIST HEALTH CARE URGENT CARE CENTERS, INC.
Entity Type:Organization
Organization Name:ADVENTIST HEALTH CARE URGENT CARE CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:FORDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-315-3030
Mailing Address - Street 1:820 W DIAMOND AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-1419
Mailing Address - Country:US
Mailing Address - Phone:301-315-3176
Mailing Address - Fax:
Practice Address - Street 1:14421 BALTIMORE AVENUE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707
Practice Address - Country:US
Practice Address - Phone:240-786-6684
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care