Healthcare Provider Details

I. General information

NPI: 1205290384
Provider Name (Legal Business Name): HEALTHY CHOICE URGENT CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2016
Last Update Date: 04/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 CENTRAL AVE STE. 301
HYATTSVILLE MD
20785-4808
US

IV. Provider business mailing address

8900 CENTRAL AVE STE. 301
HYATTSVILLE MD
20785-4808
US

V. Phone/Fax

Practice location:
  • Phone: 301-613-9295
  • Fax:
Mailing address:
  • Phone: 301-613-9295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR184425
License Number StateMD

VIII. Authorized Official

Name: VICTORIA O TITUS
Title or Position: OWNER
Credential: FNP
Phone: 301-613-9295