| Cci | |
|
8630 Fenton St Suite 1200 Silver Spring MD 20910-3806 | |
| (301) 585-1250 | |
| (301) 585-6289 |
| Full Name | Cci |
|---|---|
| Speciality | Clinic/Center |
| Location | 8630 Fenton St, Silver Spring, Maryland |
| Authorized Official Name and Position | Sonya J Bruton (CEO & PRESIDENT) |
| Authorized Official Contact | 2408395107 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cci 8665 Georgia Ave Silver Spring MD 20910-3405 Ph: (301) 340-7525 | Cci 8630 Fenton St Suite 1200 Silver Spring MD 20910-3806 Ph: (301) 585-1250 |
| NPI Number | 1124169073 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 11/09/2023 |
| Medicare PECOS PAC ID | 6204722614 |
|---|---|
| Medicare Enrollment ID | O20111129000021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124169073 | NPI | - | NPPES |
| 130061000 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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