Healthcare Provider Details
I. General information
NPI: 1497475040
Provider Name (Legal Business Name): ST. MARY'S COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/01/2022
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
21580 PEABODY ST
LEONARDTOWN MD
20650-2962
US
IV. Provider business mailing address
PO BOX 316
LEONARDTOWN MD
20650-0316
US
V. Phone/Fax
- Phone: 301-475-4330
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174H00000X |
| Taxonomy | Health Educator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MEENAKSHI
GARG
BREWSTER
Title or Position: HEALTH OFFICER
Credential:
Phone: 301-475-4317