Healthcare Provider Details

I. General information

NPI: 1780008003
Provider Name (Legal Business Name): THE PRIMARY CARE COALITION OF MONTGOMERY COUNTY, MARYLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2014
Last Update Date: 02/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 CALHOUN PL STE 600
ROCKVILLE MD
20855-3701
US

IV. Provider business mailing address

8757 GEORGIA AVE FL 10
SILVER SPRING MD
20910-3737
US

V. Phone/Fax

Practice location:
  • Phone: 240-777-4699
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVEN GALEN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 301-628-3469