Provider Demographics
NPI:1467495523
Name:CHARLES COUNTY COUNTY COMMISSIONERS
Entity Type:Organization
Organization Name:CHARLES COUNTY COUNTY COMMISSIONERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-609-3403
Mailing Address - Street 1:PO BOX 17004
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-0428
Mailing Address - Country:US
Mailing Address - Phone:301-609-3403
Mailing Address - Fax:
Practice Address - Street 1:10425 AUDLE LANE
Practice Address - Street 2:
Practice Address - City:LAPLATA
Practice Address - State:MD
Practice Address - Zip Code:20646
Practice Address - Country:US
Practice Address - Phone:301-609-3400
Practice Address - Fax:301-609-3410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCK086OtherBCBS GROUP PROVIDER #
MD406085700Medicaid
MD386BCHOtherBCBS GROUP PROVIDER #
MD386BCHOtherBCBS GROUP PROVIDER #