Healthcare Provider Details

I. General information

NPI: 1790484236
Provider Name (Legal Business Name): QUICK CARE CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2023
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1922 W PRATT STREET
BALTIMORE MD
21223-1934
US

IV. Provider business mailing address

1922 W PRATT STREET
BALTIMORE MD
21223-1934
US

V. Phone/Fax

Practice location:
  • Phone: 301-536-0044
  • Fax: 410-630-7505
Mailing address:
  • Phone: 301-536-0044
  • Fax: 410-630-7505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EJERENWA COLMAN
Title or Position: CEO
Credential:
Phone: 301-536-0044