Provider Demographics
NPI:1811433394
Name:AMBIENT MEDICAL CARE LLC
Entity type:Organization
Organization Name:AMBIENT MEDICAL CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-629-3099
Mailing Address - Street 1:800 S SALISBURY BLVD
Mailing Address - Street 2:UNIT M
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-6266
Mailing Address - Country:US
Mailing Address - Phone:302-629-3099
Mailing Address - Fax:302-629-6059
Practice Address - Street 1:800 S SALISBURY BLVD
Practice Address - Street 2:UNIT M
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-6266
Practice Address - Country:US
Practice Address - Phone:302-629-3099
Practice Address - Fax:302-629-6059
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMBIENT MEDICAL CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care