Ambush Pediatrics And Family Medical Clinic
LBN: Ambush Pediatrics And Family Medical Clinic
Ambush Pediatrics And Family Medical Clinic is an health care organization with primary practice located at 4367 Hollins Ferry Rd Ste 1C , Halethorpe MD 21227-3400. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Ambulatory Health Care Facilities / Health Service. Allopathic & Osteopathic Physicians / Adolescent Medicine is the primary health care specialty.
Ambush Pediatrics And Family Medical Clinic can be contacted via phone (410) 609-6677, or through Ambush, Jacqueline Ebony via phone (410) 707-5947.
Contact Information
Primary practice address
4367 Hollins Ferry Rd Ste 1C
Halethorpe MD 21227-3400
Phone: (410) 609-6677
Fax: (410) 609-6672
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 207QA0000X | ||
| Ambulatory Health Care Facilities / Health Service | 261QH0100X |
Profile Details
| NPI number | 1457956948 |
|---|---|
| LBN Legal business name | Ambush Pediatrics And Family Medical Clinic |
| DBA Doing business as | |
| Authorized official | Ambush, Jacqueline Ebony DNP |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 2nd, 2020 |
| Last updated | Dec 2nd, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457956948 | NPPES |
| Maryland | MEDICAID | 080454100 |
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