Provider Demographics
NPI:1447958152
Name:EMPIRICAL DIAGNOSTIC AND HEALTH SERVICES
Entity type:Organization
Organization Name:EMPIRICAL DIAGNOSTIC AND HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ADOMAH
Authorized Official - Last Name:AGYEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-389-3066
Mailing Address - Street 1:13610 CROSSBILL ALY
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-3413
Mailing Address - Country:US
Mailing Address - Phone:443-450-8514
Mailing Address - Fax:
Practice Address - Street 1:13975 CONNECTICUT AVE STE 250
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-2900
Practice Address - Country:US
Practice Address - Phone:240-389-3066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service