Healthcare Provider Details

I. General information

NPI: 1649965617
Provider Name (Legal Business Name): ST. MARY'S COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 04/06/2023
Certification Date: 04/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21625 GREAT MILLS RD
LEXINGTON PARK MD
20653-1239
US

IV. Provider business mailing address

PO BOX 316
LEONARDTOWN MD
20650-0316
US

V. Phone/Fax

Practice location:
  • Phone: 301-904-8949
  • Fax: 301-363-7800
Mailing address:
  • Phone: 301-475-4330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MEENAKSHI GARG BREWSTER
Title or Position: HEALTH OFFICER
Credential: MD
Phone: 301-475-4317