Provider Demographics
NPI:1801358445
Name:ALLCARE MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:ALLCARE MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:NOU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:800-988-1744
Mailing Address - Street 1:525 MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4314
Mailing Address - Country:US
Mailing Address - Phone:800-988-1744
Mailing Address - Fax:
Practice Address - Street 1:525 MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4314
Practice Address - Country:US
Practice Address - Phone:800-988-1744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty