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General NPI Number Information
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NPI Number | 1679842462
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Entity Type | Organization
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Legal Business Name | GARRETT COUNTY PERSONAL HEALTH
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Dates
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Enumeration Date | 12/22/2011
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 1025 MEMORIAL DR 1025 MEMORIAL DRIVE
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City | OAKLAND
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State | MD
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Zip | 21550-4343
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Country | US
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Telephone | 301-334-7700
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Fax | 301-334-7717
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Provider Business Mailing Address
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Address Line | 1025 MEMORIAL DR 1025 MEMORIAL DRIVE
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City | OAKLAND
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State | MD
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Zip | 21550-4343
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Country | US
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Telephone | 301-334-7700
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Fax | 301-334-7717
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JENNIFER HARE
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Credential |
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Telephone | 301-334-7703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | STATE AGENCY
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License Number State | MD
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