MEDICARE: POTOMAC PROMPT MEDICAL CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1568785830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POTOMAC PROMPT MEDICAL CARE, LLC

Provider Business Mailing Address
First Line	:	350 FORTUNE TER
Second Line	:
City	:	POTOMAC
State	:	MD
Zip	:	20854-2981
Country	:	US
Telephone Number	:	301-309-0016
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 FORTUNE TER
Second Line	:
City	:	POTOMAC
State	:	MD
Zip	:	20854-2981
Country	:	US
Telephone Number	:	301-309-0016
Fax Number	:	301-309-0174

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	MS. PATRICIA A WASON
Credential	:
Telephone Number	:	301-309-0016

Provider Enumeration Date	:	03/01/2010
Last Update Date	:	03/01/2010

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