Provider Demographics
NPI:1417226770
Name:ST. MARY'S COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:ST. MARY'S COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEENAKSHI
Authorized Official - Middle Name:GARG
Authorized Official - Last Name:BREWSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:301-475-4317
Mailing Address - Street 1:21580 PEABODY ST
Mailing Address - Street 2:P.O. BOX 316
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-0316
Mailing Address - Country:US
Mailing Address - Phone:301-475-4330
Mailing Address - Fax:301-475-4350
Practice Address - Street 1:21580 PEABODY ST
Practice Address - Street 2:
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-0316
Practice Address - Country:US
Practice Address - Phone:301-475-4330
Practice Address - Fax:301-475-4350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-15
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD22893OtherJOHNS HOPKINS HEALTH CARE
MD420864100Medicaid
MD704941200OtherMD PHYSICAIANS CARE
MD55005001OtherBLUE CROSS
MD0702882OtherUNITED HEALTH CARE
MD64590OtherAMERCAID COMMUNITY CARE
MDS035STOtherBLUE CROSS/BLUE SHIELD
MD731503100Medicaid
MD731503100Medicaid
MD041713100Medicaid
MD231MMedicare PIN
MD0702882OtherUNITED HEALTH CARE