Ft Meade Meddac

NPI #1164507703 in Fort Meade, Maryland

Provider Information

NPI Number: 1164507703
Entity Type: Organization
Organization Name: Ft Meade Meddac
Subpart: Yes (part of a larger organization)
Parent Organization: FT MEADE MEDDAC
Primary Specialty: Clinic/Center - Military and U.S. Coast Guard Ambulatory Procedure
Enumeration Date: Oct 25, 2006
Last Updated: May 21, 2025

Practice Location

Address: 2480 LLEWELLYN AVE
City: Fort Meade
State: Maryland
ZIP Code: 20755-5800
Phone: (301) 677-8800

Authorized Official

Name: TERRI KIMBROW
Title: UBO MANAGER
Phone: (301) 677-8512

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Military/U.S. Coast Guard Outpatient — Military/U.S. Coast Guard Outpatient	261QM1100X
Military/U.S. Coast Guard Pharmacy	332000000X
Clinic/Center - Military and U.S. Coast Guard Ambulatory Procedure — Military and U.S. Coast Guard Ambulatory Procedure	261QM1101X	Primary

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