Healthcare Provider Details

I. General information

NPI: 1467427047
Provider Name (Legal Business Name): WESTERN MARYLAND HEALTH CARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1027 MEMORIAL DR
OAKLAND MD
21550-4343
US

IV. Provider business mailing address

1027 MEMORIAL DR
OAKLAND MD
21550-4343
US

V. Phone/Fax

Practice location:
  • Phone: 301-533-3300
  • Fax: 833-448-0361
Mailing address:
  • Phone: 301-533-3300
  • Fax: 301-533-3299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MR. BRIAN G BAILEY
Title or Position: CEO
Credential:
Phone: 301-533-3300