| Reginald S Lourie Center For Infants & Young Children | |
|
12301 Academy Way Rockville MD 20852-2000 | |
| (301) 984-4444 | |
| (301) 881-8073 |
| Full Name | Reginald S Lourie Center For Infants & Young Children |
|---|---|
| Speciality | Clinic/center |
| Location | 12301 Academy Way, Rockville, Maryland |
| Authorized Official Name and Position | Tracye A Polson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3019844444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reginald S Lourie Center For Infants & Young Children 12301 Academy Way Rockville MD 20852-2000 Ph: (301) 984-4444 | Reginald S Lourie Center For Infants & Young Children 12301 Academy Way Rockville MD 20852-2000 Ph: (301) 984-4444 |
| NPI Number | 1326091810 |
|---|---|
| Provider Enumeration Date | 05/18/2006 |
| Last Update Date | 05/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326091810 | NPI | - | NPPES |
| 266561100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 11020 (Maryland) | Primary |
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