DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: ANTIETAM FAMILY HEALTH, LLC

MEDICARE: ANTIETAM FAMILY HEALTH, LLC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner
2101YP2500XProfessional Counselor
3363LF0000XFamily Nurse Practitioner

General Provider Information

NPI Number : 1578332029
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANTIETAM FAMILY HEALTH, LLC
Provider Business Mailing Address
First Line : 1219 MOUNT AETNA RD STE 201
Second Line :
City : HAGERSTOWN
State : MD
Zip : 21742-6550
Country : US
Telephone Number : 240-203-8864
Fax Number : 240-866-8173
Provider Business Practice Location Address
First Line : 330 FREDERICK ST
Second Line :
City : HAGERSTOWN
State : MD
Zip : 21740-6112
Country : US
Telephone Number : 240-203-8864
Fax Number :
Authorized Official
Title or Position : OWNER/PROVIDER
Name : MARK ANTHONY RONCONE
Credential :
Telephone Number : 240-203-8864
Provider Enumeration Date : 12/26/2023
Last Update Date : 02/24/2026

Similar Medicare Providers

1922496892 — WELLS HOUSE INC
Practice Location Address:
330 FREDERICK ST
HAGERSTOWN, MD
21740-6112
Practice Phone: 301-739-7748
Practice Fax: 301-739-4001
1235643255 — MRS. CHRISTINA TRENTON NEE LCSW-C
Practice Location Address:
330 FREDERICK ST
HAGERSTOWN, MD
21740-6112
Practice Phone: 301-739-7748
Practice Fax: 301-739-4001
1407513153 — WELLS HOUSE, INC
Practice Location Address:
330 FREDERICK ST
HAGERSTOWN, MD
21740-6112
Practice Phone: 301-739-7748
Practice Fax:
1083450449 — WELLS HOUSE INC
Practice Location Address:
330 FREDERICK ST
HAGERSTOWN, MD
21740-6112
Practice Phone: 301-739-7748
Practice Fax:
1144030081 — MRS. KATHLEEN GLADMON LMSW
Practice Location Address:
330 FREDERICK ST
HAGERSTOWN, MD
21740-6112
Practice Phone: 301-739-7748
Practice Fax:
1801600432 — ANTIETAM FAMILY HEALTH LLC
Practice Location Address:
330 FREDERICK ST
HAGERSTOWN, MD
21740-6112
Practice Phone: 240-203-8864
Practice Fax:

Directions to “ANTIETAM FAMILY HEALTH, LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.