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General NPI Number Information
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NPI Number | 1447071220
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Entity Type | Organization
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Legal Business Name | CAREBRIDGE PRIMARY AND URGENT CARE LLC
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Dates
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Enumeration Date | 10/23/2024
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 6700 RIDGE RD STE 2
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City | ROSEDALE
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State | MD
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Zip | 21237-3960
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Country | US
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Telephone | 240-350-1131
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Fax |
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Provider Business Mailing Address
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Address Line | 6202 BIRCHWOOD AVE
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City | BALTIMORE
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State | MD
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Zip | 21214-1101
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PRINCE OJONG
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Credential |
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Telephone | 332-330-4685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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