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General NPI Number Information
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NPI Number | 1447143334
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Entity Type | Organization
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Legal Business Name | CHOPTANK COMMUNITY HEALTH SYSTEM INC
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 125 RUTHSBURG RD
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City | CENTREVILLE
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State | MD
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Zip | 21617-2095
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Country | US
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Telephone | 667-319-2037
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Fax | 833-464-3704
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Provider Business Mailing Address
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Address Line | 125 RUTHSBURG RD
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City | CENTREVILLE
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State | MD
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Zip | 21617-2095
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Country | US
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Telephone | 667-319-2037
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Fax | 833-464-3704
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Authorized Official
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Title or Position | CEO
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Name | SARA RICH
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Credential |
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Telephone | 410-479-4306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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