Healthcare Provider Details

I. General information

NPI: 1023007820
Provider Name (Legal Business Name): GARRETT COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 07/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 N FOURTH ST
OAKLAND MD
21550-1375
US

IV. Provider business mailing address

251 N FOURTH ST
OAKLAND MD
21550-1375
US

V. Phone/Fax

Practice location:
  • Phone: 301-533-4220
  • Fax: 301-533-4208
Mailing address:
  • Phone: 301-533-4220
  • Fax: 301-533-4208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number110005
License Number StateMD

VIII. Authorized Official

Name: MRS. TRACY DAWN LIPSCOMB
Title or Position: VP FINANCE CFO
Credential: CPA
Phone: 301-533-4171