PREVENTION &MANAGEMENT OUTREACH CLINIC INC.

COLUMBIA, MD
NPI1619122504
Former Legal Business NamePREVENTION & MANAGEMENT OUTREACH CLINIC INC.
Entity TypeOrganization
Authorized ContactLISA BUSH
President/CEO
410-312-3126
Organization Subpart ?Yes
Primary Taxonomy305R00000X Preferred Provider Organization
Additional Taxonomies305R00000X Preferred Provider Organization
305R00000X Preferred Provider Organization
(Licence: MD  0000000000)
305R00000X Preferred Provider Organization
(Licence: MD  30500000x)
Enumeration Date2008-11-19
Last Update Date2008-11-19
Business Address
PREVENTION &MANAGEMENT OUTREACH CLINIC INC.
5941 MILLRACE CT UNIT D103
COLUMBIA, MD 21045-7204
Phone number: 410-312-3126
Mailing Address
PREVENTION &MANAGEMENT OUTREACH CLINIC INC.
5941 MILLRACE CT UNIT D103
COLUMBIA, MD 21045-7204
Phone number: 410-312-3126
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