Provider Demographics
| NPI: | 1427248269 |
|---|---|
| Name: | QUEEN ANNE'S COUNTY DEPARTMENT OF HEALTH |
| Entity type: | Organization |
| Organization Name: | QUEEN ANNE'S COUNTY DEPARTMENT OF HEALTH |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | HEALTH OFFICER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | CHINNADURAI |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | DEVADASON |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 410-758-0720 |
| Mailing Address - Street 1: | 206 N COMMERCE ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | CENTREVILLE |
| Mailing Address - State: | MD |
| Mailing Address - Zip Code: | 21617-1049 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 410-758-0720 |
| Mailing Address - Fax: | 410-758-2838 |
| Practice Address - Street 1: | 891 LOVE POINT RD |
| Practice Address - Street 2: | |
| Practice Address - City: | STEVENSVILLE |
| Practice Address - State: | MD |
| Practice Address - Zip Code: | 21666-2189 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 410-604-3731 |
| Practice Address - Fax: | 410-604-3798 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | Yes |
| Parent Organization LBN: | QUEEN ANNE'S COUNTY DEPARTMENT OF HEALTH |
| Parent Organization TIN: | <UNAVAIL> |
| Enumeration Date: | 2007-07-27 |
| Last Update Date: | 2007-07-27 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 251K00000X | Agencies | Public Health or Welfare |