Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Prevention &management Outreach Clinic Inc

Organization Preferred Provider Organization · NPI 1619122504

Prevention &management Outreach Clinic Inc is a Preferred Provider Organization in Columbia, Maryland. Licensed in Maryland. Registered with an NPI since 2008.

Licensed in
MD
In the registry since
2008
Specialties on file
4
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5941 Millrace Ct Unit D103
Columbia, MD 21045-7204
Phone: (410) 312-3126
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Preferred Provider Organization (primary) Taxonomy 305R00000X
Preferred Provider Organization Taxonomy 305R00000X (MD)
Preferred Provider Organization Taxonomy 305R00000X · Licence 0000000000 (MD)
Preferred Provider Organization Taxonomy 305R00000X · Licence 30500000X (MD)

Record details

NPI number1619122504
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organization438-31-0969
Authorized official Lisa Bush — President/Ceo · (410) 312-3126
Other names Prevention & Management Outreach Clinic Inc.
NPI enumeratedNovember 19, 2008
Last updated in NPPESNovember 19, 2008
Mailing address5941 Millrace Ct Unit D103, Columbia, MD 21045-7204

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