Provider Demographics
NPI:1770180283
Name:UMMS AMBULATORY CARE LLC
Entity Type:Organization
Organization Name:UMMS AMBULATORY CARE LLC
Other - Org Name:UNIVERSITY OF MARYLAND URGENT CARE-FALLSTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT, CLINICAL INT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:CONOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-337-1500
Mailing Address - Street 1:900 ELKRIDGE LANDING RD FL 2
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2924
Mailing Address - Country:US
Mailing Address - Phone:443-462-5010
Mailing Address - Fax:
Practice Address - Street 1:2315 BEL AIR RD STE C1
Practice Address - Street 2:
Practice Address - City:FALLSTON
Practice Address - State:MD
Practice Address - Zip Code:21047-2741
Practice Address - Country:US
Practice Address - Phone:443-345-2650
Practice Address - Fax:443-345-2666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-07
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care