MEDICARE: MONTGOMERY COUNTY MARYLAND GOVERNMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QC1500X	Community Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003237181
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTGOMERY COUNTY MARYLAND GOVERNMENT

Provider Business Mailing Address
First Line	:	401 HUNGERFORD DR FL 6
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20850-4154
Country	:	US
Telephone Number	:	240-777-4520
Fax Number	:

Provider Business Practice Location Address
First Line	:	12900 MIDDLEBROOK RD
Second Line	:
City	:	GERMANTOWN
State	:	MD
Zip	:	20874-2672
Country	:	US
Telephone Number	:	240-777-3272
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. JAMEELAH JOHNSON
Credential	:
Telephone Number	:	240-773-1211

Provider Enumeration Date	:	12/17/2013
Last Update Date	:	05/08/2024

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Directions to “MONTGOMERY COUNTY MARYLAND GOVERNMENT ” Practice Location

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