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1902966542

NPI Code Detail

MEDICARE: ALLEGANY COUNTY HEALTH DEPARTMENT

MEDICARE: ALLEGANY COUNTY HEALTH DEPARTMENT

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	324500000X	Substance Abuse Rehabilitation Facility	16298	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	055998	OTHER		PRIORITY PARTNERS (MCO)
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	02IO	OTHER		MAGELLAN
4	604116-02	OTHER		CAREFIRST BCBS
5	323817	OTHER		VALUE OPTIONS
6	277593	OTHER		MAMSI
7	351541	OTHER		MAMSI
8	5098907	OTHER		UBH (MCO)
9	IO	OTHER		MAGELLAN
10	NU1	OTHER		GHMSI

General Provider Information

NPI Number	:	1902966542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEGANY COUNTY HEALTH DEPARTMENT

Provider Business Mailing Address
First Line	:	PO BOX 1745
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21501-1745
Country	:	US
Telephone Number	:	301-759-5000
Fax Number	:	301-777-5674

Provider Business Practice Location Address
First Line	:	10102 COUNTRY CLUB RD SE
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-8339
Country	:	US
Telephone Number	:	301-777-2285
Fax Number	:	301-777-5832

Authorized Official
Title or Position	:	HEALTH OFFICER
Name	:	DR. SUE RAVER
Credential	:	MD, MPH
Telephone Number	:	301-759-5001

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	08/06/2013

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Directions to “ALLEGANY COUNTY HEALTH DEPARTMENT ” 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.

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