Healthcare Provider Details

I. General information

NPI: 1093197345
Provider Name (Legal Business Name): MOBILE MEDICAL CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2015
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19735 GERMANTOWN RD SUITE 300
GERMANTOWN MD
20874-1214
US

IV. Provider business mailing address

12320 PARKLAWN DR
ROCKVILLE MD
20852-1726
US

V. Phone/Fax

Practice location:
  • Phone: 301-493-2400
  • Fax:
Mailing address:
  • Phone: 301-841-0833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: YUHANIS SALEH
Title or Position: DIRECTOR OF FINANCE & ADMIN
Credential:
Phone: 301-841-0833