Provider Demographics
NPI:1770221152
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:FISCAL ACCOUNTS TECH II
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-262-4413
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:410-758-4023
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:410-758-4023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-25
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251K00000XAgenciesPublic Health or Welfare
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD251K00000XOtherNPPES