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NPI Code Detail

MEDICARE: PRINCE GEORGES COUNTY HEALTH DEPARTMENT

MEDICARE: PRINCE GEORGES 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
1251S00000XCommunity/Behavioral Health AgencySC1093MD

General Provider Information

NPI Number : 1750838777
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRINCE GEORGES COUNTY HEALTH DEPARTMENT
Provider Business Mailing Address
First Line : 3316 BERO RD
Second Line :
City : BALTIMORE
State : MD
Zip : 21227-4701
Country : US
Telephone Number : 410-660-7589
Fax Number :
Provider Business Practice Location Address
First Line : 925 BRIGHTSEAT RD
Second Line :
City : LANDOVER
State : MD
Zip : 20785-4725
Country : US
Telephone Number : 301-909-2437
Fax Number :
Authorized Official
Title or Position : ADDICTION COUNSELOR
Name : MS. DANA MURPHY
Credential : CSC-AD
Telephone Number : 410-660-7589
Provider Enumeration Date : 09/07/2016
Last Update Date : 09/07/2016

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Directions to “PRINCE GEORGES COUNTY HEALTH DEPARTMENT ” Practice Location

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