| Dept Of Health - Mars Estates School Wellness Ctr | |
|
1500 E Homberg Ave Essex MD 21221-3717 | |
| (410) 887-4130 | |
| (410) 377-9646 |
| Full Name | Dept Of Health - Mars Estates School Wellness Ctr |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 1500 E Homberg Ave, Essex, Maryland |
| Authorized Official Name and Position | David C Taylor (PRIVACY OFFICER) |
| Authorized Official Contact | 4108872077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dept Of Health - Mars Estates School Wellness Ctr 6401 York Rd 3rd Floor Baltimore MD 21212-2152 Ph: (410) 887-2077 | Dept Of Health - Mars Estates School Wellness Ctr 1500 E Homberg Ave Essex MD 21221-3717 Ph: (410) 887-4130 |
| NPI Number | 1376812198 |
|---|---|
| Provider Enumeration Date | 12/22/2011 |
| Last Update Date | 04/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376812198 | NPI | - | NPPES |
| 420943500 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |
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