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6180 Old Central Ave Capitol Heights MD 20743-6148 | |
| (301) 888-2333 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 6180 Old Central Ave, Capitol Heights, Maryland |
| Authorized Official Name and Position | Jeffrey A Kurcab (CFO) |
| Authorized Official Contact | 3015992172 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
7450 Albert Rd Fl 3 Brandywine MD 20613-3035 Ph: (301) 888-2233 | 6180 Old Central Ave Capitol Heights MD 20743-6148 Ph: (301) 888-2333 |
| NPI Number | 1922827831 |
|---|---|
| Provider Enumeration Date | 10/08/2024 |
| Last Update Date | 12/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922827831 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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