Organization
REVERED MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOSEPHINE MOORE NP (MANAGING OWNER)
(240) 856-1391
Entity
Organization
Contact information
Practice address
6246 MONTROSE RD, NORTH BETHESDA, MD 20852-4119
(240) 856-1393
Mailing address
PO BOX 2151, ROCKVILLE, MD 20847-2151
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
09/15/2019
Last updated
07/26/2021
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