LOWER SHORE IMMEDIATE CARE LLC NPI 1679927982

NPI Information

NPI: 1679927982
Provider Name: LOWER SHORE IMMEDIATE CARE LLC
Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

CLIA Number: 21D2120583

Address:
12302 SOMERSET AVE
SUITE A/B
PRINCESS ANNE, MD
ZIP 21853
Phone: (410) 651-0300
Get Directions

LOWER SHORE IMMEDIATE CARE LLC is an urgent care clinic center in Princess Anne, MD. LOWER SHORE IMMEDIATE CARE LLC NPI is 1679927982. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

12302 SOMERSET AVE
SUITE A/B
PRINCESS ANNE, MD
ZIP 21853-099
Phone: (410) 651-0300
Fax: (302) 947-4433

The provider's authorized official is Kim Frock .
The authorized official title is Contracting And Credentialing and has the following contact phone number (605) 789-6661.

The CLIA number assigned to this NPI record is 21D2120583 - other - urgent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/22/2016 and was last updated on 12/2/2016.

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	Primary
1	207Q00000X	Family Medicine		No
2	261QU0200X	Clinic/Center	Urgent Care	Yes
3	363AM0700X	Physician Assistant	Medical	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	533525	MEDICARE PIN	MARYLAND

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »