Provider Demographics
NPI:1700208584
Name:QUEEN ANNE'S COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:QUEEN ANNE'S COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:CIOTOLA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:410-758-0720
Mailing Address - Street 1:206 N COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21617-1049
Mailing Address - Country:US
Mailing Address - Phone:410-758-0720
Mailing Address - Fax:
Practice Address - Street 1:206 N COMMERCE ST
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:MD
Practice Address - Zip Code:21617-1049
Practice Address - Country:US
Practice Address - Phone:410-758-0720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD522033500Medicaid