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Organization

CIVISTA CLINICAL SERVICES, L.L.C.

Active
Parent organization
CIVISTA CARE PARTNERS, INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
CIVISTA CARE PARTNERS, INC.
Authorized official
GARY HERBEK (SVP COO)
(301) 609-4141
Entity
Organization

Contact information

Practice address
701 CHARLES ST, LA PLATA, MD 20646-5930
(301) 609-4000
Mailing address
PO BOX 1070, 701 EAST CHARLES STREET, LA PLATA, MD 20646-1070
(301) 609-4000

Taxonomy

Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary

Other

Enumeration date
07/20/2007
Last updated
07/20/2007
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