Provider Demographics
NPI:1639995012
Name:THE CLINIC LLC
Entity type:Organization
Organization Name:THE CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER AND FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LUCIA
Authorized Official - Middle Name:SILVA
Authorized Official - Last Name:VANORMER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:301-200-8640
Mailing Address - Street 1:10770 COLUMBIA PIKE # 300-1104
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-4402
Mailing Address - Country:US
Mailing Address - Phone:301-200-8640
Mailing Address - Fax:234-409-4121
Practice Address - Street 1:10770 COLUMBIA PIKE # 300-1104
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-4402
Practice Address - Country:US
Practice Address - Phone:301-200-8640
Practice Address - Fax:234-409-4121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center