Provider Demographics
NPI:1205244415
Name:CAREMED URGENT CARE LLC
Entity type:Organization
Organization Name:CAREMED URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIPUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MANGAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-698-9400
Mailing Address - Street 1:4856 MUDDLER WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6650
Mailing Address - Country:US
Mailing Address - Phone:703-698-9400
Mailing Address - Fax:703-698-9403
Practice Address - Street 1:11213 LEE HWY
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-5698
Practice Address - Country:US
Practice Address - Phone:703-698-9400
Practice Address - Fax:703-698-9403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101251504261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care