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General NPI Number Information
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NPI Number | 1164452181
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Entity Type | Organization
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Legal Business Name | ST AGNES HEALTHCARE
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 700 GEIPE RD
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City | CATONSVILLE
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State | MD
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Zip | 21228-4147
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Country | US
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Telephone | 410-368-8750
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Fax | 410-368-8751
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Provider Business Mailing Address
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Address Line | PO BOX 21182
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City | BALTIMORE
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State | MD
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Zip | 21228-0682
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Country | US
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Telephone | 410-368-8640
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Fax | 410-368-8644
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Authorized Official
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Title or Position | CEO
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Name | MRS. BONNIE LAMDIN PHIPPS
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Credential |
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Telephone | 410-368-2101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | MD
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