Healthcare Provider Details
I. General information
NPI: 1093485914
Provider Name (Legal Business Name): THREE LOWER COUNTIES COMMUNITY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/14/2021
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9958 N. MAIN STREET
BERLIN MD
21811
US
IV. Provider business mailing address
PO BOX 1978
SALISBURY MD
21802-1978
US
V. Phone/Fax
- Phone: 410-973-2820
- Fax: 410-973-2843
- Phone: 410-749-1015
- Fax: 410-749-0654
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
BRIAN
E
HOLLAND
Title or Position: CEO/PRESIDENT
Credential:
Phone: 410-749-1015