| |
100 Seymour Ave St. Michael's MD 21663-2930 | |
(410) 745-2882 | |
(410) 479-1714 |
Full Name | |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 100 Seymour Ave, St. Michael's, 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 |
---|---|
100 Seymour Ave St Michaels MD 21663-2930 Ph: (410) 745-2882 | 100 Seymour Ave St. Michael's MD 21663-2930 Ph: (410) 745-2882 |
NPI Number | 1689985194 |
---|---|
Provider Enumeration Date | 06/30/2010 |
Last Update Date | 10/30/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1689985194 | NPI | - | NPPES |
784381000 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Maryland) | Primary |