| Organization Name: | GREATER BADEN MEDICAL SERVICES INCORPORATED |
| NPI Number: | 1083950521 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | COLENTHIA A MALLOY (CHIEF EXECUTIVE OFFICE) |
| Mailing Address: | 6188 Oxon Hill Rd Suite 801 Oxon Hill |
| State: | MD US |
| Postal Code: | 207453113 |
| Phone Number: | 3016861665 |
| Fax Number: | 3016861190 |
| NPI Enumeration Date: | 01/02/2013 |
| NPI Last Update Date: | 02/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |