Provider Demographics
NPI:1720337546
Name:ST. AGNES HOSPITAL
Entity type:Organization
Organization Name:ST. AGNES HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAPNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUEHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-368-8858
Mailing Address - Street 1:1910 TOWNE CENTRE BLVD
Mailing Address - Street 2:APT 613
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401
Mailing Address - Country:US
Mailing Address - Phone:630-209-5038
Mailing Address - Fax:
Practice Address - Street 1:1910 TOWNE CENTRE BLVD
Practice Address - Street 2:APT 613
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401
Practice Address - Country:US
Practice Address - Phone:630-209-5038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital