Healthcare Provider Details

I. General information

NPI: 1982487740
Provider Name (Legal Business Name): BALTIMORE COUNTY GOVERNMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2023
Last Update Date: 08/16/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 RESOURCE DR
RANDALLSTOWN MD
21133-4733
US

IV. Provider business mailing address

6401 YORK RD
BALTIMORE MD
21212-2152
US

V. Phone/Fax

Practice location:
  • Phone: 410-887-0613
  • Fax:
Mailing address:
  • Phone: 410-887-2077
  • Fax: 410-377-9646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: DAVID C TAYLOR
Title or Position: HIPAA PRIVACY OFFICER
Credential:
Phone: 410-887-2077