Organization
KIMBROUGH AMBULATORY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMIE F CONAWAY-MANSON LPN (LPM)
(301) 677-8771
Entity
Organization
Contact information
Practice address
2480 LLEWELLYN AVE, FORT GEORGE G MEADE, MD 20755-5800
(301) 677-8771
Mailing address
311 REGIMENT CT, ODENTON, MD 21113-2617
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
Other
Enumeration date
01/09/2007
Last updated
08/22/2020
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