1265556815 NPI number — ALLEGANY COUNTY HEALTH DEPARTMENT

Table of content: (NPI 1265556815)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265556815 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:
ALLEGANYCOUNTY HEALTH DEPARTMENT
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:
1265556815
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/15/2014
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:
12501- 12503 WILLOWBROOK RD
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:
21502-2569
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-759-5000
Provider Business Practice Location Address Fax Number:
301-777-5674
Provider Enumeration Date:
03/19/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RAVER
Authorized Official First Name:
SUE
Authorized Official Middle Name:
Authorized Official Title or Position:
HEALTH OFFICER
Authorized Official Telephone Number:
301-759-5001

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  903069 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X , with the licence number: 903070 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QC1500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM2800X , with the licence number: 903068 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 147701060 . This is a "MPC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8480502 . This is a "UBH (MCO)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 702001500 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: K002K0 . This is a "MAGELLAN BEHAVIORAL HEALT" identifier . This identifiers is of the category "OTHER".
  • Identifier: VA01 . This is a "CAREFIRST BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1059446 . This is a "CIGNA" 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: 604116-04 . This is a "CAREFIRST BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 88888888 . This is a "CAREFIRST BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 55752NO . This is a "PRIORITY PARTNERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8480502 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0180409 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: KO . This is a "MAGELLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: NU1 . This is a "GHMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: O2KO . This is a "MAGELLAN" identifier . This identifiers is of the category "OTHER".