Provider Demographics
NPI:1518705813
Name:PMA URGENT CARE LLC
Entity type:Organization
Organization Name:PMA URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PIERRE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DIOMI
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:202-763-0897
Mailing Address - Street 1:10076 DUMFRIES RD # 80A
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-7949
Mailing Address - Country:US
Mailing Address - Phone:703-424-9941
Mailing Address - Fax:888-814-0934
Practice Address - Street 1:10076 DUMFRIES RD # 80A
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-7949
Practice Address - Country:US
Practice Address - Phone:703-424-9941
Practice Address - Fax:888-814-0934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1619521051OtherINDIVIDUAL NPI