Healthcare Provider Details

I. General information

NPI: 1619321981
Provider Name (Legal Business Name): ADVENTIST HEALTH CARE URGENT CARE CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2016
Last Update Date: 03/22/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14421 BALTIMORE AVENUE
LAUREL MD
20707
US

IV. Provider business mailing address

820 W DIAMOND AVE SUITE 500
GAITHERSBURG MD
20878-1419
US

V. Phone/Fax

Practice location:
  • Phone: 240-786-6684
  • Fax:
Mailing address:
  • Phone: 301-315-3176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. TERRY FORDE
Title or Position: PRESIDENT
Credential:
Phone: 301-315-3030