Healthcare Provider Details

I. General information

NPI: 1407597552
Provider Name (Legal Business Name): PREMIER CHOICE PRIMARY & URGENT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12301 OLD COLUMBIA PIKE STE 100A
SILVER SPRING MD
20904-1659
US

IV. Provider business mailing address

12301 OLD COLUMBIA PIKE STE 100A
SILVER SPRING MD
20904-1659
US

V. Phone/Fax

Practice location:
  • Phone: 301-598-0725
  • Fax: 301-598-0729
Mailing address:
  • Phone: 301-598-0725
  • Fax: 301-598-0729

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: CLARA EVANS
Title or Position: PROVIDER
Credential:
Phone: 240-855-4923