Provider Demographics
NPI:1245642578
Name:THE PRIMARY CARE COALITION OF MONTGOMERY COUNTY, MARYLAND, INC.
Entity type:Organization
Organization Name:THE PRIMARY CARE COALITION OF MONTGOMERY COUNTY, MARYLAND, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:GALEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-628-3649
Mailing Address - Street 1:8757 GEORGIA AVE FL 10
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3737
Mailing Address - Country:US
Mailing Address - Phone:301-628-3469
Mailing Address - Fax:301-608-8099
Practice Address - Street 1:8757 GEORGIA AVE FL 10
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3737
Practice Address - Country:US
Practice Address - Phone:301-628-3469
Practice Address - Fax:301-608-8099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health