MEDICARE: WEST CECIL HEALTH CENTER 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	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1528625332
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST CECIL HEALTH CENTER INC.

Provider Business Mailing Address
First Line	:	PO BOX 99
Second Line	:
City	:	CONOWINGO
State	:	MD
Zip	:	21918-0099
Country	:	US
Telephone Number	:	443-731-2977
Fax Number	:	410-378-0787

Provider Business Practice Location Address
First Line	:	1319 WOODBRIDGE STATION WAY
Second Line	:
City	:	EDGEWOOD
State	:	MD
Zip	:	21040-3852
Country	:	US
Telephone Number	:	410-378-9696
Fax Number	:	410-378-0787

Authorized Official
Title or Position	:	CEO
Name	:	MR. JOHN RAGNAR NESS
Credential	:
Telephone Number	:	443-731-2971

Provider Enumeration Date	:	05/28/2019
Last Update Date	:	02/12/2024

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