MEDICARE: CHARLESTOWN COMMUNITY INC

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	251E00000X	Home Health Agency	HH7137	MD

General Provider Information

NPI Number	:	1407804933
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARLESTOWN COMMUNITY INC

Provider Business Mailing Address
First Line	:	701 MAIDEN CHOICE LN
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21228-5968
Country	:	US
Telephone Number	:	410-247-3400
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 MAIDEN CHOICE LN
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21228-5968
Country	:	US
Telephone Number	:	410-247-3400
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. MICHAEL E. CONROD
Credential	:
Telephone Number	:	410-247-3400

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	08/22/2020

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Directions to “CHARLESTOWN COMMUNITY INC ” Practice Location

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