Healthcare Provider Details

I. General information

NPI: 1730136532
Provider Name (Legal Business Name): LUMINIS HEALTH DOCTORS COMMUNITY MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8118 GOOD LUCK RD
LANHAM MD
20706-3595
US

IV. Provider business mailing address

8118 GOOD LUCK RD
LANHAM MD
20706-3595
US

V. Phone/Fax

Practice location:
  • Phone: 301-552-0044
  • Fax:
Mailing address:
  • Phone: 443-481-4035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number16-022
License Number StateMD

VIII. Authorized Official

Name: JASON VELLEN
Title or Position: DIRECTOR, PATIENT FINANCIAL SERVICE
Credential:
Phone: 443-481-4035