Provider Demographics
NPI:1245706878
Name:MAGASS URGENT CARE, LLC
Entity type:Organization
Organization Name:MAGASS URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGASSOUBA
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:443-487-4053
Mailing Address - Street 1:PO BOX 24265
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4493
Mailing Address - Country:US
Mailing Address - Phone:443-487-4053
Mailing Address - Fax:443-906-0610
Practice Address - Street 1:2970 DEDE RD STE 4
Practice Address - Street 2:
Practice Address - City:FINKSBURG
Practice Address - State:MD
Practice Address - Zip Code:21048-2349
Practice Address - Country:US
Practice Address - Phone:443-487-4053
Practice Address - Fax:443-906-0961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-22
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD010249100Medicaid