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NPI Code Detail

MEDICARE: MEDSTAR URGENT CARE, LLC

MEDICARE: MEDSTAR URGENT 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
1261QU0200XUrgent Care Clinic/Center

General Provider Information

NPI Number : 1720402340
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDSTAR URGENT CARE, LLC
Provider Business Mailing Address
First Line : 228 7TH ST SE
Second Line :
City : WASHINGTON
State : DC
Zip : 20003-4306
Country : US
Telephone Number : 202-698-0795
Fax Number : 202-698-0794
Provider Business Practice Location Address
First Line : 228 7TH ST SE
Second Line :
City : WASHINGTON
State : DC
Zip : 20003-4306
Country : US
Telephone Number : 202-698-0795
Fax Number : 202-698-0794
Authorized Official
Title or Position : CORPORATE VICE PRESIDENT
Name : DEBORAH KUCHKA-CRAIG
Credential :
Telephone Number : 410-772-6827
Provider Enumeration Date : 02/18/2014
Last Update Date : 02/18/2014

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