1053753616 NPI number — HOWARD COUNTY HEALTH DEPARTMENT

Table of content: (NPI 1053753616)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053753616 NPI number — HOWARD COUNTY HEALTH DEPARTMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOWARD COUNTY HEALTH DEPARTMENT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BOLLMAN BRIDGE ELEMENTARY SCHOOL-BASED WELLNESS CENTER
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053753616
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/25/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8930 STANDFORD BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21045
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-313-6363
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8200 SAVAGE GUILFORD ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAVAGE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20763
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-880-5920
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/24/2013

Additional Information

Authorized Official

Authorized Official Last Name:
ROSSMAN
Authorized Official First Name:
MAURA
Authorized Official Middle Name:
Authorized Official Title or Position:
HEALTH OFFICER
Authorized Official Telephone Number:
410-313-6363

Provider Taxonomy Codes

  • Taxonomy code: 261QS1000X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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