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EDEN HEALTH CLINIC INC NPI 1285310847


NPI Information

NPI: 1285310847
Provider Name: EDEN HEALTH CLINIC INC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 21D2285049

Address:
481 N FREDERICK AVE STE 103
GAITHERSBURG, MD
ZIP 20877
Phone: (240) 203-8881
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EDEN HEALTH CLINIC INC is a family medicine in Gaithersburg, MD. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. EDEN HEALTH CLINIC INC NPI is 1285310847. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

481 N FREDERICK AVE STE 103
GAITHERSBURG, MD
ZIP 20877-470
Phone: (240) 203-8881

The provider's authorized official is Ruby Lee .
The authorized official title is Authorized Official and has the following contact phone number (240) 203-8881.

The CLIA number assigned to this NPI record is 21D2285049 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/27/2023 and was last updated on 2/9/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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