Healthcare Provider Details

I. General information

NPI: 1780284448
Provider Name (Legal Business Name): FREDERICK HEALTH HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2020
Last Update Date: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 FREDERICK HEALTH WAY
FREDERICK MD
21701-9435
US

IV. Provider business mailing address

1 FREDERICK HEALTH WAY
FREDERICK MD
21701-9435
US

V. Phone/Fax

Practice location:
  • Phone: 240-566-3222
  • Fax: 240-566-3961
Mailing address:
  • Phone: 240-566-3222
  • Fax: 240-566-3961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE K. MAHAN
Title or Position: SR. VP AND CFO
Credential:
Phone: 240-566-3337