Provider Demographics
NPI:1871843409
Name:MEDSTAR URGENT CARE, LLC
Entity Type:Organization
Organization Name:MEDSTAR URGENT CARE, LLC
Other - Org Name:MEDSTAR PROMPTCARE-WHEATON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. CRED/PAYOR SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-933-3073
Mailing Address - Street 1:11915 GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2065
Mailing Address - Country:US
Mailing Address - Phone:301-942-4505
Mailing Address - Fax:301-942-4509
Practice Address - Street 1:11915 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-2065
Practice Address - Country:US
Practice Address - Phone:301-942-4505
Practice Address - Fax:301-942-4509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care