Healthcare Provider Details

I. General information

NPI: 1912405200
Provider Name (Legal Business Name): WICOMICO COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2018
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 NEWTON ST
SALISBURY MD
21801-5452
US

IV. Provider business mailing address

108 E MAIN ST
SALISBURY MD
21801-4921
US

V. Phone/Fax

Practice location:
  • Phone: 410-543-6930
  • Fax:
Mailing address:
  • Phone: 410-543-6930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State

VIII. Authorized Official

Name: MR. MATTHEW MCCONAUGHEY
Title or Position: HEALTH OFFICER
Credential: MPH
Phone: 410-543-6930