Krystal Medical Associates
LBN: Krystal Medical Associates Llc
Krystal Medical Associates is an health care organization with primary practice located at 12150 Annapolis Rd Suite 100, Glenn Dale MD 20769-9183. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Multi-Specialty, Ambulatory Health Care Facilities / Primary Care. Ambulatory Health Care Facilities / Primary Care is the primary health care specialty.
Krystal Medical Associates Llc can be contacted via phone (301) 464-7601, or through Onyeaghala, Nwaehihie H via phone (301) 486-0100.
Contact Information
Primary practice address
12150 Annapolis Rd Suite 100
Glenn Dale MD 20769-9183
Phone: (301) 464-7601
Fax: (866) 885-9817
Website:
Authorized official contact:
Name: Onyeaghala, Nwaehihie H Doctor of Medicine (MD)
Phone: (301) 486-0100
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Multi-Specialty | 261QM1300X | D0053461 | Maryland |
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | D0053461 | Maryland |
Profile Details
| NPI number | 1164604187 |
|---|---|
| LBN Legal business name | Krystal Medical Associates Llc |
| DBA Doing business as | Krystal Medical Associates |
| Authorized official | Onyeaghala, Nwaehihie H Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 30th, 2007 |
| Last updated | Aug 18th, 2014 - about 12 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164604187 | NPPES |
| Maryland | MEDICAID | 402647100 | |
| Maryland | MEDICAID | 010012902 | |
| Maryland | MEDICAID | 034934800 |
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