Healthcare Provider Details
I. General information
NPI: 1942579073
Provider Name (Legal Business Name): HARFORD COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/19/2011
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1321 WOODBRIDGE STATION WAY
EDGEWOOD MD
21040-3830
US
IV. Provider business mailing address
120 S HAYS ST
BEL AIR MD
21014-3615
US
V. Phone/Fax
- Phone: 410-612-1779
- Fax: 410-612-9183
- Phone: 410-877-1033
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public Health or Welfare Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARCY
R
AUSTIN
Title or Position: DEPUTY HEALTH OFFICER
Credential:
Phone: 410-877-1033