NPIMap

Organization Active NPI

Alydan, LLC

  • Health Service Clinic/Center
  • West Friendship, MD
National Provider Identifier
1891198453
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
0104001076 Issued in VA
Legal business name
ALYDAN, LLC
Practice address
13125 Fox Path LN
West Friendship, MD 21794-9536
Phone
(540) 287-1776
NPI assigned
Sep 26, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Authorized official

Name
Dr. Glenn B. Molin, D.C.NPI 1871960344
Title
Member Manager
Phone
(540) 287-1776

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 0104001076 VA Primary

Addresses

Primary practice location

13125 Fox Path LN
West Friendship, MD 21794-9536

Mailing address

13125 Fox Path LN
West Friendship, MD 21794-9536
Phone (540) 287-1776

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411689600000",
    "number": "1891198453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13125 FOX PATH LN",
            "city": "WEST FRIENDSHIP",
            "state": "MD",
            "postal_code": "217949536",
            "telephone_number": "540-287-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13125 FOX PATH LN",
            "city": "WEST FRIENDSHIP",
            "state": "MD",
            "postal_code": "217949536",
            "telephone_number": "540-287-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALYDAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-26",
        "last_updated": "2014-09-26",
        "status": "A",
        "authorized_official_last_name": "MOLIN",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "540-287-1776",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "VA",
            "license": "0104001076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Friendship, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.