Provider Demographics
NPI:1518602481
Name:ST. MARY'S COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:ST. MARY'S COUNTY HEALTH DEPARTMENT
Other - Org Name:ST. MARY'S COUNTY HEALTH DEPARTMENT- SBHC SPRING RIDGE
Other - Org Type:Other Name
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MEENAKSHI
Authorized Official - Middle Name:GARG
Authorized Official - Last Name:BREWSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-475-4317
Mailing Address - Street 1:PO BOX 316
Mailing Address - Street 2:
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:
Practice Address - Street 1:19856 THREE NOTCH RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-3560
Practice Address - Country:US
Practice Address - Phone:301-863-4031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. MARY'S COUNTY HEALTH DEPARTMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-04
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health