Type 1 Individual Provider

LBN: Type 1 Individual Provider
Type 1 Individual Provider is an health care organization with primary practice located at 1620 Elton Rd , Silver Spring MD 20903-1740. The organization recently has only one registered license in Managed Care Organizations / Exclusive Provider Organization, which is considered as the primary health care specialty. Type 1 Individual Provider can be contacted via phone (301) 439-7191, or through Gibson, Brena via phone (301) 439-7191.

Contact Information

Primary practice address
1620 Elton Rd Silver Spring MD 20903-1740
Phone: (301) 439-7191
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Gibson, Brena P.H.D
Phone: (301) 439-7191

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Exclusive Provider Organization 302F00000X LC2381 Maryland

Profile Details

NPI number 1952543191
LBN Legal business name Type 1 Individual Provider
DBA Doing business as Type 1 Individual Provider
Authorized official Gibson, Brena P.H.D
Entity Organization
Organization subpart 1 No
Enumeration date Apr 2nd, 2009
Last updated Apr 8th, 2009 - about 16 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.

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