Provider Demographics
NPI:1003236001
Name:HEALTHY CHOICE FAMILY CLINIC AND URGENT CARE, LLC
Entity type:Organization
Organization Name:HEALTHY CHOICE FAMILY CLINIC AND URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT /OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TITUS
Authorized Official - Suffix:
Authorized Official - Credentials:TITUS
Authorized Official - Phone:301-613-9295
Mailing Address - Street 1:8700 CENTRAL AVE
Mailing Address - Street 2:SUITE 302 A
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-4831
Mailing Address - Country:US
Mailing Address - Phone:301-613-9295
Mailing Address - Fax:888-202-7717
Practice Address - Street 1:8700 CENTRAL AVE
Practice Address - Street 2:SUITE # 302A
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-4831
Practice Address - Country:US
Practice Address - Phone:301-613-9295
Practice Address - Fax:888-202-7717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-17
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR184425261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR184425OtherMARYLAND STATE LICENSE