Provider Demographics
NPI:1629788120
Name:LOWER SHORE CLINIC, INC
Entity Type:Organization
Organization Name:LOWER SHORE CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OUTPATIENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:R
Authorized Official - Last Name:GARLITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-341-3420
Mailing Address - Street 1:208 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-4923
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11559 SOMERSET AVE
Practice Address - Street 2:
Practice Address - City:PRINCESS ANNE
Practice Address - State:MD
Practice Address - Zip Code:21853-1067
Practice Address - Country:US
Practice Address - Phone:410-341-3420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOWER SHORE CLINIC, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-25
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health