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General NPI Number Information
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NPI Number | 1598581084
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Entity Type | Organization
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Legal Business Name | CALVERTHEALTH MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 11/29/2024
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Last Update Date | 11/29/2024
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Provider Practice Location Address
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Address Line | 130 HOSPITAL RD STE 102
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-4029
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Country | US
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Telephone | 410-846-8800
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Fax | 410-469-1724
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Provider Business Mailing Address
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Address Line | 100 HOSPITAL RD
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-4017
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Country | US
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Telephone | 410-414-4791
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | CAROLYN HEITHAUS
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Credential |
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Telephone | 410-535-8236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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