Organization
OWENSVILLE PRIMARY CARE,INC
Active
Organization
OWENSVILLE PRIMARY CARE,INC
Active
Parent organization
1225110067
Organization subpart
Yes
Provider details
NPI number
Legal business name
1225110067
Authorized official
CHRISTINA VARGA (REVENUE CYCLE MANAGER)
(410) 867-4700
Entity
Organization
Contact information
Practice address
5408 SOUTHERN MARYLAND BLVD UNIT 7, LOTHIAN, MD 20711-2602
(410) 867-4700
(410) 867-4934
Mailing address
134 OWENSVILLE RD, WEST RIVER, MD 20778-9702
(410) 867-4700
(410) 867-4934
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
05/21/2021
Last updated
01/02/2025
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