Provider Demographics
NPI:1881002012
Name:MONOCACY HEALTH PARTNERS LLC
Entity Type:Organization
Organization Name:MONOCACY HEALTH PARTNERS LLC
Other - Org Name:MT AIRY HEALTH SERVICES IMMEDIATE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VP AND CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-566-3355
Mailing Address - Street 1:1502 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-5325
Mailing Address - Country:US
Mailing Address - Phone:301-829-5888
Mailing Address - Fax:
Practice Address - Street 1:1502 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-5325
Practice Address - Country:US
Practice Address - Phone:301-829-5888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONOCACY HEALTH PARTNERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care