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4910 Macon Rd Rockville MD 20852-2228 | |
| (240) 777-1550 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 4910 Macon Rd, Rockville, Maryland |
| Authorized Official Name and Position | Timothy Firestine (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Contact | 2407772500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
101 Monroe St Rockville MD 20850-2503 Ph: (240) 777-2500 | 4910 Macon Rd Rockville MD 20852-2228 Ph: (240) 777-1550 |
| NPI Number | 1114348927 |
|---|---|
| Provider Enumeration Date | 12/20/2013 |
| Last Update Date | 12/20/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114348927 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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