Healthcare Provider Details

I. General information

NPI: 1881878668
Provider Name (Legal Business Name): UNION BRIDGE FAMILY HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2007
Last Update Date: 12/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 N MAIN ST
UNION BRIDGE MD
21791-9100
US

IV. Provider business mailing address

P.O. BOX 595 5 N MAIN ST
UNION BRIDGE MD
21791
US

V. Phone/Fax

Practice location:
  • Phone: 410-775-7272
  • Fax: 410-775-7697
Mailing address:
  • Phone: 410-775-7272
  • Fax: 410-775-7697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberP00795
License Number StateMD

VIII. Authorized Official

Name: MARK L MCINTYRE
Title or Position: OWNER
Credential:
Phone: 410-775-7272