Healthcare Provider Details

I. General information

NPI: 1194768473
Provider Name (Legal Business Name): THREE LOWER COUNTIES COMMUNITY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 10/25/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 TREE SAP CT
SALISBURY MD
21804
US

IV. Provider business mailing address

1615 TREE SAP CT
SALISBURY MD
21804-9403
US

V. Phone/Fax

Practice location:
  • Phone: 410-677-0561
  • Fax: 410-677-0562
Mailing address:
  • Phone: 410-677-0561
  • Fax: 410-677-0562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP04378
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP07848
License Number StateMD

VIII. Authorized Official

Name: MR. BRIAN E HOLLAND
Title or Position: PRESIDENT & CEO
Credential:
Phone: 410-749-1015