MEDICARE: PEOPLES COMMUNITY HEALTH CENTER

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	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1225071939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEOPLES COMMUNITY HEALTH CENTER

Provider Business Mailing Address
First Line	:	3011 GREENMOUNT AVENUE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21218
Country	:	US
Telephone Number	:	410-467-6040
Fax Number	:

Provider Business Practice Location Address
First Line	:	3011 GREENMOUNT AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21218-3939
Country	:	US
Telephone Number	:	410-467-6040
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. PATRICIA S CASSATT
Credential	:	MS
Telephone Number	:	410-467-6040

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	08/22/2020

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Directions to “PEOPLES COMMUNITY HEALTH CENTER ” Practice Location

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