Provider Demographics
NPI:1093197287
Name:MOBILE MEDICAL CARE, INC
Entity type:Organization
Organization Name:MOBILE MEDICAL CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE & ADMINISTRATIO
Authorized Official - Prefix:
Authorized Official - First Name:YUHANIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SALEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-841-0833
Mailing Address - Street 1:12320 PARKLAWN DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1726
Mailing Address - Country:US
Mailing Address - Phone:301-493-2400
Mailing Address - Fax:240-235-7075
Practice Address - Street 1:202. S SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2316
Practice Address - Country:US
Practice Address - Phone:301-493-2400
Practice Address - Fax:240-235-7075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-24
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD423888500Medicaid