| |
12145 Elm Street Princess Anne MD 21853 | |
(410) 651-5135 | |
(410) 651-4682 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 12145 Elm Street, Princess Anne, Maryland |
Authorized Official Name and Position | Susanne M. Gray (PRESIDENT & CEO) |
Authorized Official Contact | 4107491015 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1978 Salisbury MD 21802-1978 Ph: (410) 749-1015 | 12145 Elm Street Princess Anne MD 21853 Ph: (410) 651-5135 |
NPI Number | 1184757445 |
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Provider Enumeration Date | 03/14/2007 |
Last Update Date | 01/30/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184757445 | NPI | - | NPPES |
119591300 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Rite Med Group Of Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11974 Edgehill Terrace Rd, Princess Anne, MD 21853 Phone: 410-651-0011 | |
Focus Point Solutions Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11672 Somerset Ave, Princess Anne, MD 21853 Phone: 443-866-2311 | |