Organization
MALCOLM GROW MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET BERRY (MEDICAL STAFF PROFESSIONAL)
(240) 612-2473
Entity
Organization
Contact information
Practice address
1060 W PERIMETER RD, JB ANDREWS, MD 20762-6602
(240) 612-1836
Mailing address
1060 W PERIMETER RD, JB ANDREWS, MD 20762-6602
Taxonomy
Speciality
Code
Description
License number
State
332100000X
Department of Veterans Affairs (VA) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518379395
MGMCSC
—
Enumeration date
02/26/2025
Last updated
02/26/2025
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