Provider Demographics
NPI:1356147524
Name:COMMUNITY PRIMARY CARE ASSOCIATES L.L.C
Entity type:Organization
Organization Name:COMMUNITY PRIMARY CARE ASSOCIATES L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER/OWNET
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:STAMBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:240-439-1251
Mailing Address - Street 1:110 BAUGHMANS LN STE 206
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4059
Mailing Address - Country:US
Mailing Address - Phone:240-439-1251
Mailing Address - Fax:703-459-6733
Practice Address - Street 1:110 BAUGHMANS LN STE 206
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4059
Practice Address - Country:US
Practice Address - Phone:240-439-1251
Practice Address - Fax:307-459-6733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-19
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care