Healthcare Provider Details

I. General information

NPI: 1679972020
Provider Name (Legal Business Name): WEST CECIL HEALTH CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2014
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 ROCK SPRINGS RD
CONOWINGO MD
21918-1352
US

IV. Provider business mailing address

PO BOX 99
CONOWINGO MD
21918-0099
US

V. Phone/Fax

Practice location:
  • Phone: 410-378-9696
  • Fax: 410-378-0787
Mailing address:
  • Phone: 410-378-9696
  • Fax: 410-378-9925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN RAGNAR NESS
Title or Position: PRESIDENT & CEO
Credential:
Phone: 410-378-9696