| Pioneer City Health Center | |
|
8341 Pioneer Drive Severn MD 21144 | |
| (410) 467-6040 | |
| Not Available |
| Full Name | Pioneer City Health Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 8341 Pioneer Drive, Severn, Maryland |
| Authorized Official Name and Position | Patricia Cassatt (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4102358801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pioneer City Health Center 2204 Maryland Ave Baltimore MD 21218-5625 Ph: (410) 467-6040 | Pioneer City Health Center 8341 Pioneer Drive Severn MD 21144 Ph: (410) 467-6040 |
| NPI Number | 1912976796 |
|---|---|
| Provider Enumeration Date | 03/15/2006 |
| Last Update Date | 12/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912976796 | NPI | - | NPPES |
| 910561100 | Medicaid | MD | |
| H649 | Other | MD | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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