Eden Health Clinic Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

EDEN HEALTH CLINIC INC

Practice address

481 N Frederick Ave Ste 103
Gaithersburg, MD 20877-2470

Phone

(240) 203-8881

NPI assigned

Jun 27, 2023

Organization subpart

No

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

Authorized official

Name

Ruby LeeNPI 1689274847

Title

Authorized Official

Phone

(240) 203-8881

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ruby Lee

  • Pharmacist
  • Gaithersburg, MD
  • NPI 1689274847
  NPD Authorized official
• Jiho Choi, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Annandale, VA
  • NPI 1225149859

  DC

  Medicare reassignment
• Kwang SE Lee, PHARMD

  • Pharmacist
  • Gaithersburg, MD
  • NPI 1811632425
  NPD (past)

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755043200000",
    "number": "1285310847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 N FREDERICK AVE STE 103",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772470",
            "telephone_number": "240-203-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 N FREDERICK AVE STE 103",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772470",
            "telephone_number": "240-203-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN HEALTH CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-27",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "RUBY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "240-203-8881"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saida Eazizayene
• Kalyn Ebb
• Nancy Ebb, LCSW C
• Echostat LLC
• Loribeth Eckard
• Eden Pharmacology Center
• Patricia Ann Edmister, PHD
• Edon Healthcare Services, Inc.
• Antonia Lattice Edwards
• Mirshelle Edwards

• Multi-Specialty Clinic/Center in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Multi-Specialty Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.