Healthcare Provider Details

I. General information

NPI: 1104989417
Provider Name (Legal Business Name): ANNE ARUNDEL CO. DEPT. OF HLTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HARRY S. TRUMAN PKWY
ANNAPOLIS MD
21401
US

IV. Provider business mailing address

3 HARRY S. TRUMAN PKWY
ANNAPOLIS MD
21401
US

V. Phone/Fax

Practice location:
  • Phone: 410-222-7135
  • Fax: 410-222-4173
Mailing address:
  • Phone: 410-222-7135
  • Fax: 410-222-4173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. CECELIA LYNN THOMAS
Title or Position: OFFICE MANAGER, ACCOUNTS RECEIVABLE
Credential:
Phone: 410-222-7135