Healthcare Provider Details

I. General information

NPI: 1720395338
Provider Name (Legal Business Name): AMBIENT CARE OF MARYLAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2010
Last Update Date: 12/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 S SALISBURY BLVD UNIT M
SALISBURY MD
21801-6266
US

IV. Provider business mailing address

PO BOX 1827
SEAFORD DE
19973-8827
US

V. Phone/Fax

Practice location:
  • Phone: 410-603-8457
  • Fax: 302-629-6059
Mailing address:
  • Phone: 410-603-8457
  • Fax: 302-629-6059

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: ROBERT HENRY
Title or Position: OWNER/ MANAGER
Credential:
Phone: 410-603-8457