MEDICARE: PEOPLES COMMUNITY HEALTH CENTERS

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	3336C0002X	Clinic Pharmacy	PW0244	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2127327	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1689774648
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEOPLES COMMUNITY HEALTH CENTERS

Provider Business Mailing Address
First Line	:	3013 GREENMOUNT AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21218-3939
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3013 GREENMOUNT AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21218-3939
Country	:	US
Telephone Number	:	443-872-7792
Fax Number	:	410-467-2448

Authorized Official
Title or Position	:	CEO
Name	:	PATRICIA CASSATT
Credential	:	MS
Telephone Number	:	410-467-6040

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	08/22/2020

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Directions to “PEOPLES COMMUNITY HEALTH CENTERS ” Practice Location

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