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 |