Organization Active NPI

Potomac Healthcare Alliance LLC

  • Pain Clinic/Center
  • Frederick, MD
National Provider Identifier
1245582832
Registry record updated Jan 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
POTOMAC HEALTHCARE ALLIANCE LLC
Practice address
198 Thomas Johnson Dr
Suite 5
Frederick, MD 21702-4398
Phone
(301) 624-5390
Fax
(301) 624-5393
NPI assigned
Oct 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Patrick Eskew, CEO
Title
Ceo
Phone
(301) 624-5390

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X Primary

Addresses

Primary practice location

198 Thomas Johnson Dr
Suite 5
Frederick, MD 21702-4398

Mailing address

198 Thomas Johnson Dr
Suite 5
Frederick, MD 21702-4398
Phone (301) 624-5390

National Provider Directory

National Provider Directory
Tax ID family
Potomac Healthcare Alliance LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390780800000",
    "number": "1245582832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 THOMAS JOHNSON DR",
            "address_2": "SUITE 5",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024398",
            "telephone_number": "301-624-5390",
            "fax_number": "301-624-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 THOMAS JOHNSON DR",
            "address_2": "SUITE 5",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024398",
            "telephone_number": "301-624-5390",
            "fax_number": "301-624-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC HEALTHCARE ALLIANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-08",
        "last_updated": "2014-01-27",
        "status": "A",
        "authorized_official_last_name": "ESKEW",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-624-5390",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.