MEDICARE: GARRETT COUNTY MEMORIAL HOSPITAL

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	314000000X	Skilled Nursing Facility	110005	MD

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	:	1023007820
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARRETT COUNTY MEMORIAL HOSPITAL

Provider Business Mailing Address
First Line	:	251 N FOURTH ST
Second Line	:
City	:	OAKLAND
State	:	MD
Zip	:	21550-1375
Country	:	US
Telephone Number	:	301-533-4220
Fax Number	:	301-533-4208

Provider Business Practice Location Address
First Line	:	251 N FOURTH ST
Second Line	:
City	:	OAKLAND
State	:	MD
Zip	:	21550-1375
Country	:	US
Telephone Number	:	301-533-4220
Fax Number	:	301-533-4208

Authorized Official
Title or Position	:	VP FINANCE CFO
Name	:	MRS. TRACY DAWN LIPSCOMB
Credential	:	CPA
Telephone Number	:	301-533-4171

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	07/16/2019

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Directions to “GARRETT COUNTY MEMORIAL HOSPITAL ” Practice Location

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