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General NPI Number Information
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NPI Number | 1922827831
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Entity Type | Organization
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Legal Business Name | GREATER BADEN MEDICAL SERVICE INCORPORATED
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 6180 OLD CENTRAL AVE
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City | CAPITOL HEIGHTS
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State | MD
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Zip | 20743-6148
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Country | US
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Telephone | 301-888-2333
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Fax |
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Provider Business Mailing Address
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Address Line | 7450 ALBERT RD FL 3
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City | BRANDYWINE
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State | MD
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Zip | 20613-3035
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Country | US
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Telephone | 301-888-2233
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | JEFFREY A KURCAB
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Credential |
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Telephone | 301-599-2172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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