1174821441 NPI number — WORCESTER COUNTY HEALTH DEPARTMENT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174821441 NPI number — WORCESTER COUNTY HEALTH DEPARTMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WORCESTER 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:
Provider Other Organization Name Type Code:
6
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:
1174821441
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 249
Provider Second Line Business Mailing Address:
6040 PUBLIC LANDING RAOD
Provider Business Mailing Address City Name:
SNOW HILL
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21863-0249
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-632-1100
Provider Business Mailing Address Fax Number:
410-632-2476

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 WALNUT STREET
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
POCOMOKE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21851-1501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-957-2005
Provider Business Practice Location Address Fax Number:
410-957-2417
Provider Enumeration Date:
03/10/2011

Additional Information

Authorized Official

Authorized Official Last Name:
BARTON
Authorized Official First Name:
HEATHER
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF ADMIN
Authorized Official Telephone Number:
410-632-1100

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  MH556 , 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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