Healthcare Provider Details

I. General information

NPI: 1902924574
Provider Name (Legal Business Name): CECIL COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 BOW ST JOHN M BYERS HEALTH CENTER
ELKTON MD
21921-5501
US

IV. Provider business mailing address

401 BOW ST JOHN M BYERS HEALTH CENTER
ELKTON MD
21921-5501
US

V. Phone/Fax

Practice location:
  • Phone: 410-996-5550
  • Fax: 410-996-5179
Mailing address:
  • Phone: 410-996-5550
  • Fax: 410-996-5179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. VIRGINIA R BAILEY
Title or Position: HEALTH OFFICER
Credential: M.D., M.P.H
Phone: 410-996-5550