MEDICARE: HARFORD COUNTY HEALTH DEPARTMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QS1000X	Student Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396978417
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARFORD COUNTY HEALTH DEPARTMENT

Provider Business Mailing Address
First Line	:	120 S HAYS ST
Second Line	:
City	:	BEL AIR
State	:	MD
Zip	:	21014-3615
Country	:	US
Telephone Number	:	410-877-1033
Fax Number	:	410-420-3435

Provider Business Practice Location Address
First Line	:	2100 CEDAR DR
Second Line	:
City	:	EDGEWOOD
State	:	MD
Zip	:	21040-2502
Country	:	US
Telephone Number	:	410-877-1033
Fax Number	:	410-420-3435

Authorized Official
Title or Position	:	DEPUTY HEALTH OFFICER
Name	:	MS. MARCY AUSTIN
Credential	:
Telephone Number	:	410-877-1033

Provider Enumeration Date	:	08/25/2009
Last Update Date	:	09/05/2023

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