Provider Demographics
NPI:1487469243
Name:GREATER BADEN MEDICAL SERVICE INCORPORATED
Entity type:Organization
Organization Name:GREATER BADEN MEDICAL SERVICE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KURCAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-599-2172
Mailing Address - Street 1:7450 ALBERT RD FL 3
Mailing Address - Street 2:
Mailing Address - City:BRANDYWINE
Mailing Address - State:MD
Mailing Address - Zip Code:20613-3035
Mailing Address - Country:US
Mailing Address - Phone:301-888-2233
Mailing Address - Fax:301-997-1489
Practice Address - Street 1:21729 GREAT MILLS RD STE C
Practice Address - Street 2:
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-3815
Practice Address - Country:US
Practice Address - Phone:301-888-2233
Practice Address - Fax:301-997-1489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)