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General NPI Number Information
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NPI Number | 1134442957
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Entity Type | Organization
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Legal Business Name | FREDERICK HEALTH HOSPITAL INC
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Dates
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Enumeration Date | 03/08/2010
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Last Update Date | 01/24/2020
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Provider Practice Location Address
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Address Line | 1562 OPOSSUMTOWN PIKE
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City | FREDERICK
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State | MD
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Zip | 21702-4337
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Country | US
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Telephone | 240-566-3400
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Fax | 240-566-4872
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Provider Business Mailing Address
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Address Line | 400 W 7TH ST
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City | FREDERICK
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State | MD
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Zip | 21701-4506
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Country | US
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Telephone | 240-566-3300
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Fax | 240-566-4872
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Authorized Official
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Title or Position | CFO
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Name | MS. MICHELLE K. MAHAN
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Credential |
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Telephone | 240-566-3355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 025
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License Number State | MD
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