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General NPI Number Information
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NPI Number | 1609466507
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Entity Type | Organization
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Legal Business Name | PPNS
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 01/25/2021
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Provider Practice Location Address
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Address Line | 6339 TEN OAKS RD
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City | CLARKSVILLE
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State | MD
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Zip | 21029-1137
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Country | US
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Telephone | 301-421-1214
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Fax | 301-421-4054
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Provider Business Mailing Address
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Address Line | 15646 OLD COLUMBIA PIKE
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City | BURTONSVILLE
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State | MD
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Zip | 20866-1630
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Country | US
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Telephone | 301-421-1214
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Fax | 301-421-1214
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. RACHELLE BAILEY-EL
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Credential |
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Telephone | 301-804-3081
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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 |
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License Number State |
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