Provider Demographics
NPI:1780020735
Name:FREDERICK HEALTH HOSPITAL INC
Entity Type:Organization
Organization Name:FREDERICK HEALTH HOSPITAL INC
Other - Org Name:FMH CRESTWOOD REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VP, CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-566-3355
Mailing Address - Street 1:7211 BANK CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-8483
Mailing Address - Country:US
Mailing Address - Phone:240-566-3400
Mailing Address - Fax:
Practice Address - Street 1:7211 BANK CT
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-8483
Practice Address - Country:US
Practice Address - Phone:240-566-3400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FREDERICK HEALTH HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-17
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty