1396829032 NPI number — TALBOT COUNTY HEALTH DEPARTMENT

Table of content: (NPI 1396829032)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396829032 NPI number — TALBOT COUNTY HEALTH DEPARTMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TALBOT 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:
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:
1396829032
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4504 WORLD FARM RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OXFORD
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21654-1615
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-819-5600
Provider Business Mailing Address Fax Number:
410-819-5690

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 S HANSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EASTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21601-2920
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-819-5600
Provider Business Practice Location Address Fax Number:
410-819-5690
Provider Enumeration Date:
10/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WEBB
Authorized Official First Name:
ANN
Authorized Official Middle Name:
H
Authorized Official Title or Position:
DEPUTY HEALTH OFFICER
Authorized Official Telephone Number:
410-819-5600

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: M27262 . This is a "CDS LICENSE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com