| |
1813 Sweetbay Dr Salisbury MD 21804-1663 | |
(410) 749-1022 | |
(410) 749-1149 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1813 Sweetbay Dr, Salisbury, Maryland |
Authorized Official Name and Position | Brian E Holland (PRESIDENT & CEO) |
Authorized Official Contact | 4107491015 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 1978 Salisbury MD 21802-1978 Ph: (410) 749-1015 | 1813 Sweetbay Dr Salisbury MD 21804-1663 Ph: (410) 749-1022 |
NPI Number | 1780913426 |
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Provider Enumeration Date | 12/09/2009 |
Last Update Date | 11/15/2024 |
Medicare PECOS PAC ID | 3678484300 |
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Medicare Enrollment ID | O20100330000832 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780913426 | NPI | - | NPPES |
119591300 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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