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Contact Information

PREVENTION &MANAGEMENT OUTREACH CLINIC INC.
5941 MILLRACE CT UNIT D103
COLUMBIA, MD21045-7204
 Phone: 410-312-3126
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Preferred Provider Organization

305R00000X
Indicates primary specialty

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

NPI # 1619122504
LBN Legal business name PREVENTION &MANAGEMENT OUTREACH CLINIC INC.
Authorized official LISA BUSH - (PRESIDENT/CEO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 11/19/2008
Last updated 11/19/2008 - About 18 years ago
Identifiers
MD License # 0000000000
MD License # 30500000X
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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