Healthcare Provider Details

I. General information

NPI: 1336145127
Provider Name (Legal Business Name): FREDERICK HEALTH HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 THOMAS JOHNSON DR
FREDERICK MD
21702-4673
US

IV. Provider business mailing address

400 W 7TH ST
FREDERICK MD
21701-4506
US

V. Phone/Fax

Practice location:
  • Phone: 240-566-3132
  • Fax:
Mailing address:
  • Phone: 240-566-3330
  • Fax: 240-566-4872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MS. SHELBY BOGGS
Title or Position: VICE PRESIDENT
Credential:
Phone: 443-721-4452