Healthcare Provider Details

I. General information

NPI: 1073459483
Provider Name (Legal Business Name): ST. AUGUSTINE HEALTH SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3104 LORD BALTIMORE DR
WINDSOR MILL MD
21244-2898
US

IV. Provider business mailing address

3104 LORD BALTIMORE DR
WINDSOR MILL MD
21244-2898
US

V. Phone/Fax

Practice location:
  • Phone: 410-725-2324
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: AUGUSTINE JACOBSON
Title or Position: CEO
Credential:
Phone: 410-725-2324