1598034522 NPI number — ALLEGANY COUNTY HEALTH DEPARTMENT

Table of content: (NPI 1598034522)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598034522 NPI number — ALLEGANY COUNTY HEALTH DEPARTMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLEGANY 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:
MASSIE UNIT UNDER 21
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:
1598034522
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/20/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1745
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CUMBERLAND
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21501-1745
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-759-5000
Provider Business Mailing Address Fax Number:
301-777-5674

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10102 COUNTRY CLUB ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CUMBERLAND
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-777-2285
Provider Business Practice Location Address Fax Number:
301-777-5832
Provider Enumeration Date:
12/20/2011

Additional Information

Authorized Official

Authorized Official Last Name:
RAVER
Authorized Official First Name:
SUE
Authorized Official Middle Name:
V
Authorized Official Title or Position:
HEALTH OFFICER
Authorized Official Telephone Number:
301-759-5000

Provider Taxonomy Codes

  • Taxonomy code: 324500000X , with the licence number:  16298 , 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)

  • Identifier: 604116-02 . This is a "CAREFIRST BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: NU1 . This is a "GHMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 277593 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5098907 . This is a "UBH (MCO)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 323817 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 351541 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 055998 . This is a "PRIORITY PARTNERS (MCO)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02IO . This is a "MAGELLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: IO . This is a "MAGELLAN" identifier . This identifiers is of the category "OTHER".




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