MEDICARE: FREDERICK COUNTY MARYLAND

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	10-008	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	:	1144217423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREDERICK COUNTY MARYLAND

Provider Business Mailing Address
First Line	:	1900 ROSEMONT AVE
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-8249
Country	:	US
Telephone Number	:	240-772-9200
Fax Number	:	240-608-6467

Provider Business Practice Location Address
First Line	:	1920 ROSEMONT AVE
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-8249
Country	:	US
Telephone Number	:	240-772-9200
Fax Number	:	240-608-6467

Authorized Official
Title or Position	:	DIRECTOR OF FACILITY ACCOUNTING
Name	:	BARBARA KITCHEN
Credential	:
Telephone Number	:	410-729-8406

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	11/07/2024

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Directions to “FREDERICK COUNTY MARYLAND ” Practice Location

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