MEDICARE: FREDERICK HEALTH HOSPITAL INC

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	291U00000X	Clinical Medical Laboratory	025	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	21D0220586	OTHER	MD	CLIA

General Provider Information

NPI Number	:	1134442957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREDERICK HEALTH HOSPITAL INC

Provider Business Mailing Address
First Line	:	400 W 7TH ST
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21701-4506
Country	:	US
Telephone Number	:	240-566-3300
Fax Number	:	240-566-4872

Provider Business Practice Location Address
First Line	:	1562 OPOSSUMTOWN PIKE
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-4337
Country	:	US
Telephone Number	:	240-566-3400
Fax Number	:	240-566-4872

Authorized Official
Title or Position	:	DIRECTOR, PROFESSIONAL FEES REVENUE
Name	:	JENNY FITZPATRICK
Credential	:
Telephone Number	:	240-439-8774

Provider Enumeration Date	:	03/08/2010
Last Update Date	:	03/17/2026

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