Provider Demographics
NPI:1720395338
Name:AMBIENT CARE OF MARYLAND LLC
Entity Type:Organization
Organization Name:AMBIENT CARE OF MARYLAND LLC
Other - Org Name:AMBIENT CARE VIRTUAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-603-8457
Mailing Address - Street 1:PO BOX 1827
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-8827
Mailing Address - Country:US
Mailing Address - Phone:410-603-8457
Mailing Address - Fax:302-629-6059
Practice Address - Street 1:800 S SALISBURY BLVD
Practice Address - Street 2:UNIT M
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-6266
Practice Address - Country:US
Practice Address - Phone:410-603-8457
Practice Address - Fax:302-629-6059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-02
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care