Healthcare Provider Details

I. General information

NPI: 1508946047
Provider Name (Legal Business Name): WICOMICO COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date: 08/07/2024
Reactivation Date: 09/04/2024

III. Provider practice location address

705 N SALISBURY BLVD
SALISBURY MD
21801-4120
US

IV. Provider business mailing address

108 E MAIN ST
SALISBURY MD
21801-4921
US

V. Phone/Fax

Practice location:
  • Phone: 410-334-3401
  • Fax:
Mailing address:
  • Phone: 410-543-6931
  • Fax: 410-543-6975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

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