# EMBREY MILL PRIMARY AND URGENT CARE LLC

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

## Provider details

- **NPI number:** 1790400042
- **Authorized official:** GALAM A KHAN (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (571) 332-2439

## Contact information

- **Practice address:** 1610 PUBLIX WAY \# B112, STAFFORD, VA 22554-7783
- **Practice address phone:** (571) 332-2439
- **Mailing address:** 1610 PUBLIX WAY \# B112, STAFFORD, VA 22554-7783

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/10/2022
- **Last updated:** 11/15/2022