# MAGNOLIA URGENT AND PRIMARY CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457013708
- **Authorized official:** MRS. FAITH RODEHEAVER CRNP (OWNER)
- **Authorized official phone:** (301) 616-3427

## Contact information

- **Practice address:** 121 EAST FIRST AVENUE, LOCH LYNN, MD 21550
- **Practice address phone:** (301) 616-3427
- **Mailing address:** 3506 GARRETT HWY, OAKLAND, MD 21550-2327
- **Mailing address phone:** (301) 616-3427

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/13/2021
- **Last updated:** 10/13/2021