Provider Demographics
NPI:1386390623
Name:ALLIED PRIMARY CARE ASSOCIATES LLC
Entity type:Organization
Organization Name:ALLIED PRIMARY CARE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNP
Authorized Official - Prefix:
Authorized Official - First Name:EMELDA
Authorized Official - Middle Name:IFEOMA
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:240-419-0683
Mailing Address - Street 1:11418 AMBERLEA FARM DR
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3805
Mailing Address - Country:US
Mailing Address - Phone:301-529-1142
Mailing Address - Fax:
Practice Address - Street 1:11418 AMBERLEA FARM DR
Practice Address - Street 2:
Practice Address - City:NORTH POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878-3805
Practice Address - Country:US
Practice Address - Phone:301-529-1142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1114537545OtherN/A
VA1174132344OtherN/A