National Provider Identifier Database

PREVENTION MANAGEMENT OUTREACH CLINIC INC
Preferred Provider Organization

A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.


Contact Information

PREVENTION &MANAGEMENT OUTREACH CLINIC INC.
5941 MILLRACE CT UNIT D103
COLUMBIA, MD21045-7204
Phone: 410-312-3126
Fax:
Website:
Specialty Taxonomy Code
* Preferred Provider Organization 305R00000X

* Indicates primary specialty

NPI Profile & details for PREVENTION &MANAGEMENT OUTREACH CLINIC INC.

NPI Number 1619122504
Legal business name
LBN
PREVENTION &MANAGEMENT OUTREACH CLINIC INC.
Authorized official LISA BUSH - (PRESIDENT/CEO)
Entity Organization
Organization subpart Yes
Enumeration date 11/19/2008
Last updated 11/19/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • MD License #: 0000000000
  • MD License #: 30500000X

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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