Community Clinic, INC.
Clinic/Center, Federally Qualified Health Center (FQHC) in Gaithersburg, MD. Organization (NPI-2).
NPI number1699817775
StatusActive
Last updated in NPPESNov 9, 2023
Details
- NPI
- 1699817775
- Entity type
- Organization (NPI-2)
- Legal business name
- Community Clinic, INC.
- Organization subpart
- No
- Enumeration date
- Feb 13, 2007
- Certification date
- Nov 9, 2023
- Last updated
- Nov 9, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QF0400X | Clinic/Center, Federally Qualified Health Center (FQHC) | – | – | Yes |
| 103T00000X | Psychologist | – | – | |
| 133V00000X | Dietitian, Registered | – | – | |
| 207R00000X | Internal Medicine | – | – | |
| 208000000X | Pediatrics | – | – | |
| 2080A0000X | Pediatrics, Adolescent Medicine | – | – | |
| 363LF0000X | Nurse Practitioner, Family | – | – | |
| 363LW0102X | Nurse Practitioner, Women's Health | – | – |
Practice location
220 Girard St # 100Gaithersburg, MD 20877-3467
Phone 301-216-0880 · Fax 301-216-2891
Mailing address
8665 Georgia AveSilver Spring, MD 20910-3405
Phone 301-340-7525 · Fax 301-495-0318
Authorized official
Sonya Bruton
Ceo
8665209102
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