Healthcare Provider Details

I. General information

NPI: 1568669935
Provider Name (Legal Business Name): SOUTHERN MARYLAND TRI-COUNTY COMMUNITY ACTION COMMITTEE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 SOLOMS ISLAND ROAD
HUNTINGTOWN MD
20639
US

IV. Provider business mailing address

PO BOX 280
HUGHESVILLE MD
20637-0280
US

V. Phone/Fax

Practice location:
  • Phone: 301-274-4474
  • Fax: 301-274-5971
Mailing address:
  • Phone: 301-274-4474
  • Fax: 301-274-5971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateMD

VIII. Authorized Official

Name: MR. RUSH M COX JR.
Title or Position: CFO
Credential:
Phone: 301-274-4474