Healthcare Provider Details

I. General information

NPI: 1194445809
Provider Name (Legal Business Name): THREE LOWER COUNTIES COMMUNITY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2022
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31481 OLD OCEAN CITY RD
SALISBURY MD
21804-1810
US

IV. Provider business mailing address

PO BOX 1978
SALISBURY MD
21802-1978
US

V. Phone/Fax

Practice location:
  • Phone: 410-677-3936
  • Fax:
Mailing address:
  • Phone: 410-749-1015
  • Fax: 410-749-0654

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 E HOLLAND
Title or Position: CEO/PRESIDENT
Credential:
Phone: 410-749-1015