| Colonel Richardson Middle School Sbhc | |
|
25390 Richardson Rd Federalsburg MD 21632-2403 | |
| (410) 754-9580 | |
| (833) 914-0412 |
| Full Name | Colonel Richardson Middle School Sbhc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 25390 Richardson Rd, Federalsburg, Maryland |
| Authorized Official Name and Position | Sara Rich (CEO) |
| Authorized Official Contact | 4104794306 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Colonel Richardson Middle School Sbhc 25390 Richardson Rd Federalsburg MD 21632-2403 Ph: (410) 754-9580 | Colonel Richardson Middle School Sbhc 25390 Richardson Rd Federalsburg MD 21632-2403 Ph: (410) 754-9580 |
| NPI Number | 1992936983 |
|---|---|
| Provider Enumeration Date | 08/07/2009 |
| Last Update Date | 10/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992936983 | NPI | - | NPPES |
| 784381004 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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