Healthcare Provider Details

I. General information

NPI: 1881002012
Provider Name (Legal Business Name): MONOCACY HEALTH PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2014
Last Update Date: 07/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 S MAIN ST
MOUNT AIRY MD
21771-5325
US

IV. Provider business mailing address

1502 S MAIN ST
MOUNT AIRY MD
21771-5325
US

V. Phone/Fax

Practice location:
  • Phone: 301-829-5888
  • Fax:
Mailing address:
  • Phone: 301-829-5888
  • 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: MICHELLE MAHAN
Title or Position: SR. VP AND CFO
Credential:
Phone: 240-566-3355