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General NPI Number Information
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NPI Number | 1588494553
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Entity Type | Organization
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Legal Business Name | CINQCARE IL IPA LLC
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Dates
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Enumeration Date | 08/05/2024
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 2300 N ST NW
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City | WASHINGTON
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State | DC
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Zip | 20037-1122
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Country | US
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Telephone | 310-418-7250
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Fax |
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Provider Business Mailing Address
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Address Line | 30 BROAD ST FL 23
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City | NEW YORK
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State | NY
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Zip | 10004-2919
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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 | CEO
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Name | RODNEY ARMSTEAD
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Credential | MD
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Telephone | 310-418-7250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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