Provider Demographics
NPI:1275695116
Name:COUNTY COMMISSIONERS OF QUEEN ANNES COUNTY
Entity Type:Organization
Organization Name:COUNTY COMMISSIONERS OF QUEEN ANNES COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:K
Authorized Official - Last Name:AFTUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-758-4500
Mailing Address - Street 1:100 COMMUNICATIONS DR
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21617-2140
Mailing Address - Country:US
Mailing Address - Phone:410-758-4500
Mailing Address - Fax:
Practice Address - Street 1:100 COMMUNICATIONS DR
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:MD
Practice Address - Zip Code:21617-2140
Practice Address - Country:US
Practice Address - Phone:410-758-4500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD408439000Medicaid
MD316013OtherHEALTH AMERICA
MD64684301OtherCAREFIRST BLUE CROSS
MDK788OtherFEDERAL BLUE SHIELD
P00234800Medicare PIN
MDK788OtherFEDERAL BLUE SHIELD