Provider Demographics
NPI:1265682157
Name:MORGAN CHERYL D HUDSON GROUP
Entity Type:Organization
Organization Name:MORGAN CHERYL D HUDSON GROUP
Other - Org Name:MORGAN CHERYL D LOTT GROUP II
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL D
Authorized Official - Middle Name:LOTT
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-390-3128
Mailing Address - Street 1:1809 PEACHTREE LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-3069
Mailing Address - Country:US
Mailing Address - Phone:301-390-3128
Mailing Address - Fax:301-390-2390
Practice Address - Street 1:1809 PEACHTREE LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-3069
Practice Address - Country:US
Practice Address - Phone:301-390-3128
Practice Address - Fax:301-390-2390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS146N00000X, 251B00000X, 261QM0855X, 282NC2000X, 302R00000X, 332B00000X, 3416A0800X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty
No251B00000XAgenciesCase Management
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No282NC2000XHospitalsGeneral Acute Care HospitalChildren
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3416A0800XTransportation ServicesAmbulanceAir Transport
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSH426219028Medicaid
MSH02687758Medicaid
MS00022308Medicaid