Healthcare Provider Details

I. General information

NPI: 1639700172
Provider Name (Legal Business Name): FIRST CALL MEDICAL CENTER GAMBRILLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2020
Last Update Date: 03/17/2020
Certification Date: 03/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1071 MD RT 3 N STE 101
GAMBRILLS MD
21054-1784
US

IV. Provider business mailing address

5005 SIGNAL BELL LN STE 200
CLARKSVILLE MD
21029-2608
US

V. Phone/Fax

Practice location:
  • Phone: 410-721-2333
  • Fax:
Mailing address:
  • Phone: 410-730-3399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RON ELFENBEIN
Title or Position: MEDICAL DIRECTOOR
Credential: MD
Phone: 410-721-2333