Provider Demographics
NPI:1487796835
Name:TEAM CRITICAL CARE LLC
Entity type:Organization
Organization Name:TEAM CRITICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:NORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-740-8550
Mailing Address - Street 1:8041 CESSNA AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-4169
Mailing Address - Country:US
Mailing Address - Phone:301-740-8550
Mailing Address - Fax:301-740-7442
Practice Address - Street 1:8041 CESSNA AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-4169
Practice Address - Country:US
Practice Address - Phone:301-740-8550
Practice Address - Fax:301-740-7442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD341600000X
MD123341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD412316600Medicaid
MD591SMedicare PIN