| Frederick Community Action Agency | |
|
100 S Market St Frederick MD 21701-5527 | |
| (301) 600-1506 | |
| Not Available |
| Full Name | Frederick Community Action Agency |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 S Market St, Frederick, Maryland |
| Authorized Official Name and Position | Ramenta Cottrell (DIRECTOR) |
| Authorized Official Contact | 3016003955 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Frederick Community Action Agency 100 S Market St Frederick MD 21701-5527 Ph: (301) 600-1506 | Frederick Community Action Agency 100 S Market St Frederick MD 21701-5527 Ph: (301) 600-1506 |
| NPI Number | 1588105316 |
|---|---|
| Provider Enumeration Date | 03/13/2017 |
| Last Update Date | 11/02/2021 |
| Medicare PECOS PAC ID | 1355626649 |
|---|---|
| Medicare Enrollment ID | O20170329001391 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588105316 | NPI | - | NPPES |
| 200175600 | Medicaid | MD | |
| 21D0885241 | Other | MD | CLIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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