Provider Demographics
NPI:1992455158
Name:ADVANCED PRIMARY CARE AND ALTERNATIVE MEDICINE, LLC
Entity type:Organization
Organization Name:ADVANCED PRIMARY CARE AND ALTERNATIVE MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SMALL
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:301-302-3704
Mailing Address - Street 1:19813 LEITERSBURG PIKE # 136
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-1445
Mailing Address - Country:US
Mailing Address - Phone:301-302-3704
Mailing Address - Fax:717-655-7868
Practice Address - Street 1:20009 ROSEBANK WAY
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6739
Practice Address - Country:US
Practice Address - Phone:301-733-3353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty