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General NPI Number Information
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NPI Number | 1063864080
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Entity Type | Organization
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Legal Business Name | AMBIENT MEDICAL CARE, LLC
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Dates
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Enumeration Date | 07/02/2016
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Last Update Date | 07/02/2016
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Provider Practice Location Address
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Address Line | 1000 MIDWAY DR SUITE 11B
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City | HARRINGTON
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State | DE
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Zip | 19952-2448
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Country | US
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Telephone | 302-629-3099
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 MIDWAY DR SUITE 11B
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City | HARRINGTON
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State | DE
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Zip | 19952-2448
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Country | US
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Telephone | 302-629-3099
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | ROBERT HENRY
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Credential |
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Telephone | 410-603-8457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 2016604668
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License Number State | DE
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