Provider Demographics
NPI:1609990258
Name:ALLEGANY COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:ALLEGANY COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MHP
Authorized Official - Phone:301-759-5001
Mailing Address - Street 1:PO BOX 1745
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21501-1745
Mailing Address - Country:US
Mailing Address - Phone:301-759-5000
Mailing Address - Fax:301-777-5674
Practice Address - Street 1:12501 WILLOWBROOK RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2554
Practice Address - Country:US
Practice Address - Phone:301-759-5093
Practice Address - Fax:301-777-5669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD323817OtherVALUE OPTIONS
MD147701060OtherMPC
MDK002K0OtherMAGELLAN BEHAVIORAL HEALT
MD1059446OtherCIGNA
MD55752NOOtherPRIORITY PARTNERS
MD8480502OtherUNITED HEALTH CARE
MD702001500Medicaid
MD720001300Medicaid
MD0180409OtherUNITED HEALTH CARE
MD351541OtherMAMSI (MDIPA, MAMSI LIFE
MDNU1OtherGHMSI (FEP, BLUE CHOICE)
MDVA01OtherBCBS
MD702001500Medicaid
MD147701060OtherMPC