Provider Demographics
NPI:1932822954
Name:AVALON HEALTH CARE INC.
Entity Type:Organization
Organization Name:AVALON HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-360-5552
Mailing Address - Street 1:401 CARROLL ST STE 106
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-5987
Mailing Address - Country:US
Mailing Address - Phone:888-360-5552
Mailing Address - Fax:301-968-1231
Practice Address - Street 1:401 CARROLL ST STE 106
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-5987
Practice Address - Country:US
Practice Address - Phone:888-360-5552
Practice Address - Fax:301-968-1231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care