Provider Demographics
NPI:1689926867
Name:UNIVERSITY MEDICAL CARE INC
Entity Type:Organization
Organization Name:UNIVERSITY MEDICAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABRHAM
Authorized Official - Middle Name:MENGESHA
Authorized Official - Last Name:AGONAFIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-831-1727
Mailing Address - Street 1:11303 AMHERST AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-4600
Mailing Address - Country:US
Mailing Address - Phone:240-833-8014
Mailing Address - Fax:240-833-8047
Practice Address - Street 1:11303 AMHERST AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-4600
Practice Address - Country:US
Practice Address - Phone:240-833-8014
Practice Address - Fax:240-833-8047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-11
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0072842261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care