PREMISE HEALTH OF MARYLAND MEDICAL P C (NPI# 1063859551) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063859551 |
| Entity Type | Organization |
| Organization Name | PREMISE HEALTH OF MARYLAND MEDICAL P C |
| Other Organization Name | FAMILY FIRST MEDICAL CENTER AND PHARMACY |
| Practice Address |
13403 Volvo Way, Medical Suite Hagerstown MD 21742 |
| Mailing Address |
5500 Maryland Way Ste 120 Brentwood TN 37027-4993 |
| Practice Telephone | 2405003764 |
| Practice Fax Number | 3017902050 |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2020-05-20 |
| Authorized Official Name | DR. JAMES M THIEL (PRESIDENT) |
| Authorized Official Telephone | 8444077557 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Family First Medical Center and Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356881387 | Premise Health of Maryland Medical P C | Clinic/Center | 8403 Colesville Rd Fl 15, Silver Spring, MD 20910-6331 | 2017-02-23 |
| 1003335621 | Premise Health of Maryland Medical P C | Clinic/Center | 6801 Rockledge Dr, Bethesda, MD 20817-1803 | 2017-09-14 |
| 1497274013 | Premise Health of Maryland Medical P C | Clinic/Center | 103 Chesapeake Park Plz, Middle River, MD 21220-4201 | 2017-09-14 |
| 1649543513 | Premise Health of Maryland Medical P C | Clinic/Center | 1 Medimmune Way, Gaithersburg, MD 20878 | 2012-02-22 |
| Street Address |
13403 VOLVO WAY, MEDICAL SUITE |
| City | HAGERSTOWN |
| State | MD |
| Zip Code | 21742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154950251 | Caleb Lougheed | Student in an Organized Health Care Education/Training Program | Meritus Family Medicine Residency Program, 11110 Medical Campus Road, Suite 200, Hagerstown, MD 21742 | 2020-04-02 |
| 1770054900 | Katherine E Spann | Physician Assistant | Meritus Medical Center, 11116 Medical Campus Road, Hagerstown, MD 21742 | 2018-12-16 |
| 1760988950 | Kelli Jones | Nurse Anesthetist, Certified Registered | 11116 Medical Center, Hagerstown, MD 21742 | 2018-04-05 |
| 1740706324 | Michael E. Anderson, Dds, PC | Dentist | 18709 Crestwood Drive, Hagerstown, MD 21742 | 2017-08-16 |
| 1407387384 | Cynthia Brendle | Physical Therapy Assistant | 19800 Tranquility Circle, Robinwood Campus, Hagerstown, MD 21742 | 2017-03-23 |
| 1326411877 | Structural Elements, LLC | Acupuncturist | 13214 Fountainhead Plaza, Hagerstown, MD 21742 | 2015-11-05 |
| 1386057396 | Ma Pamela Borden | Occupational Therapist | 506 Lynnehaven Drive, Apartment G, Hagerstown, MD 21742 | 2014-06-06 |
| 1275971251 | Arti Babubhai Patel | Denturist | 13133 Gentry Drive, Hagerstown, MD 21742 | 2013-06-12 |
| 1386938363 | Rocky Mountain Holdings LLC | Ambulance | 18539 Henson Blvd, Hagerstown, MD 21742 | 2011-06-07 |
| 1871800771 | Allan Okot Anyumba | Obstetrics & Gynecology | 10974 Sassan Ln, Hagerstown, MD 21742 | 2010-09-13 |
| Find all providers in zip 21742 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285102764 | Black Rock Integrative Medicine | Clinic/Center | 17666 Technology Blvd, Hagerstown, MD 21740-2074 | 2018-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558974543 | Dgd Healthcare Solutions,llc | Clinic/Center | 1210 Northern Lights Dr, Upper Marlboro, MD 20774-6049 | 2020-08-28 |
| 1376160382 | Trinity Family and Behavioral Health Services LLC | Clinic/Center | 15612 Norus St, Upper Marlboro, MD 20772-8253 | 2020-06-25 |
| 1255951372 | Holistic Touch Healthcare LLC | Clinic/Center | 1412 Crain Hwy N Ste 3a, Glen Burnie, MD 21061-7000 | 2020-04-18 |
| 1265068373 | Bodyworks Medical | Clinic/Center | St. Agnes Medical Center, 3455 Wilkens Ave Suite 100, Baltimore, MD 21229 | 2020-03-20 |
| 1629615901 | Regen Medical LLC | Clinic/Center | 3916 Hickory Ave, Baltimore, MD 21211-1834 | 2019-12-05 |
| 1427609429 | Active Spine & Rehab, LLC | Clinic/Center | 802 Cromwell Park Dr, Glen Burnie, MD 21061-2563 | 2019-09-23 |
| 1144888025 | Ethos Health Maryland 1, LLC | Clinic/Center | 4940 Campbell Blvd Ste 130, Nottingham, MD 21236-5910 | 2019-06-05 |
| 1740847201 | Swiftcare Family Clinic and Wellness Inc | Clinic/Center | 1841/1843 Brightseat Road, Landover, MD 20785-2078 | 2019-05-21 |
| 1639664683 | The Heard Group, LLC | Clinic/Center | 6284 Hard Bargain Cir, Indian Head, MD 20640 | 2018-06-22 |
| 1912407891 | Adoni Healthcare Services, LLC | Clinic/Center | 7525 Greenway Center Dr Ste 316, Greenbelt, MD 20770 | 2018-02-16 |
| Find all providers with the same taxonomy | ||||
| City | HAGERSTOWN |
| Zip Code | 21742 |
Please comment or provide details below to improve the information on PREMISE HEALTH OF MARYLAND MEDICAL P C.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.