| Prince George's County Health Department | |
|
3003 Hospital Drive - Ground Floor Cheverly MD 20785 | |
| (301) 583-5920 | |
| (301) 583-5953 |
| Full Name | Prince George's County Health Department |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3003 Hospital Drive - Ground Floor, Cheverly, Maryland |
| Authorized Official Name and Position | Tamala Butler (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 3018837822 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prince George's County Health Department 1701 Mccormick Dr Largo MD 20774-5329 Ph: (301) 883-7822 | Prince George's County Health Department 3003 Hospital Drive - Ground Floor Cheverly MD 20785 Ph: (301) 583-5920 |
| NPI Number | 1083945125 |
|---|---|
| Provider Enumeration Date | 01/28/2010 |
| Last Update Date | 09/17/2020 |
| Certification Date | 09/17/2020 |
| Medicare PECOS PAC ID | 0547542243 |
|---|---|
| Medicare Enrollment ID | O20200625001571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083945125 | NPI | - | NPPES |
| 419469100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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