Provider Demographics
NPI:1689774648
Name:PEOPLES COMMUNITY HEALTH CENTERS
Entity Type:Organization
Organization Name:PEOPLES COMMUNITY HEALTH CENTERS
Other - Org Name:PEOPLES COMMUNITY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASSATT
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:410-467-6040
Mailing Address - Street 1:3013 GREENMOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-3939
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3013 GREENMOUNT AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-3939
Practice Address - Country:US
Practice Address - Phone:443-872-7792
Practice Address - Fax:410-467-2448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDPW02443336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2127327OtherOTHER ID NUMBER-COMMERCIAL NUMBER