Healthcare Provider Details

I. General information

NPI: 1558082446
Provider Name (Legal Business Name): HOWARD COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2022
Last Update Date: 09/08/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9550 BASKET RING RD
COLUMBIA MD
21045-3415
US

IV. Provider business mailing address

8930 STANFORD BLVD
COLUMBIA MD
21045-5805
US

V. Phone/Fax

Practice location:
  • Phone: 410-313-6915
  • Fax:
Mailing address:
  • Phone: 410-313-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CARLETTA LYNN MCKNIGHT
Title or Position: FINANCE
Credential:
Phone: 410-313-6300