Healthcare Provider Details
I. General information
NPI: 1609694546
Provider Name (Legal Business Name): THREE LOWER COUNTIES COMMUNITY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/30/2024
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1340 S DIVISION ST STE 301
SALISBURY MD
21804-7095
US
IV. Provider business mailing address
PO BOX 1978
SALISBURY MD
21802-1978
US
V. Phone/Fax
- Phone: 410-543-2060
- Fax: 410-543-2051
- Phone: 410-749-1015
- Fax: 410-749-1020
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
BRIAN
E
HOLLAND
Title or Position: PRESIDENT/CEO
Credential:
Phone: 410-749-1015