Provider Demographics
NPI:1184059891
Name:CRESCENT URGENT HEALTH CARE SERVICES LLC
Entity type:Organization
Organization Name:CRESCENT URGENT HEALTH CARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:GHADYALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-605-8504
Mailing Address - Street 1:10540 CONNECTICUT AVE
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-2426
Mailing Address - Country:US
Mailing Address - Phone:301-949-0030
Mailing Address - Fax:301-949-0033
Practice Address - Street 1:13428 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-1264
Practice Address - Country:US
Practice Address - Phone:301-949-0030
Practice Address - Fax:301-949-0033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-12
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care