=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336964683
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DORCHESTER COUNTY HEALTH DEPARTMENT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/21/2024
-----------------------------------------------------
Last Update Date | 04/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 401 ACADEMY ST
-----------------------------------------------------
City | CAMBRIDGE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21613-1951
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-228-7714
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 627 RACE ST
-----------------------------------------------------
City | CAMBRIDGE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21613-2333
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | HEALTH OFFICER
-----------------------------------------------------
Name | CASEY SCOTT
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 410-228-3223
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251K00000X
-----------------------------------------------------
Taxonomy Name | Public Health or Welfare Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QR0405X
-----------------------------------------------------
Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------