Healthcare Provider Details

I. General information

NPI: 1669555645
Provider Name (Legal Business Name): UNION BRIDGE FAMILY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 09/19/2025
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

PO BOX 595
UNION BRIDGE MD
21791-0592
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP00795
License Number StateMD

VIII. Authorized Official

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