1508386079 NPI number — HOWARD 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 1508386079 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:
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:
1508386079
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/19/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8930 STANFORD BOULEVARD
Provider Second Line Business Mailing Address:
HOWARD COUNTY HEALTH DEPARTMENT
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21045-5805
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-313-7238
Provider Business Mailing Address Fax Number:
410-313-6108

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5460 TRUMPETER ROAD
Provider Second Line Business Practice Location Address:
HCHD WILDE LAKE HIGH SCHOOL-BASED WELLNESS CENTER
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21044-2314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-313-7238
Provider Business Practice Location Address Fax Number:
410-313-6108
Provider Enumeration Date:
06/26/2017

Additional Information

Authorized Official

Authorized Official Last Name:
MCKNIGHT
Authorized Official First Name:
CARLETTA
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
FISCAL ACCOUNT MANAGER
Authorized Official Telephone Number:
410-313-6300

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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