1821180035 NPI number — WICOMICO COUNTY HEALTH DEPT

Table of content: (NPI 1821180035)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821180035 NPI number — WICOMICO COUNTY HEALTH DEPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WICOMICO COUNTY HEALTH DEPT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821180035
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
108 E MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALISBURY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21801-4921
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-543-6931
Provider Business Mailing Address Fax Number:
410-543-6975

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
108 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALISBURY
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21801-4921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-543-6931
Provider Business Practice Location Address Fax Number:
410-543-6975
Provider Enumeration Date:
09/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BREWSTER
Authorized Official First Name:
LORI
Authorized Official Middle Name:
A
Authorized Official Title or Position:
HEALTH OFFICER
Authorized Official Telephone Number:
410-543-6930

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 720211300 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 734221700 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 55043NP . This is a "MCO PRIORITY PARTNERS -FP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 705291000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 487102200 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9500079 . This is a "MCO UNITED HEALTHCARE-SBW" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0101795 . This is a "MCO UNITED HEALTHCARE- FP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com