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General NPI Number Information
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NPI Number | 1427930684
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Entity Type | Organization
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Legal Business Name | PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 4390 PARLIAMENT PL STE A
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City | LANHAM
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State | MD
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Zip | 20706-1866
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Country | US
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Telephone | 301-883-7879
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 MCCORMICK DR STE 120
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City | LARGO
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State | MD
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Zip | 20774-5329
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Country | US
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Telephone | 240-302-8576
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | TAMALA VICKS
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Credential |
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Telephone | 240-302-8576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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