Provider Demographics
NPI:1790866432
Name:WICOMICO COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:WICOMICO COUNTY HEALTH DEPARTMENT
Other - Org Name:WICOMICO COUNTY BEHAVORIAL HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCONAUGHEY
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:410-543-6930
Mailing Address - Street 1:108 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-4921
Mailing Address - Country:US
Mailing Address - Phone:410-543-6931
Mailing Address - Fax:410-543-6975
Practice Address - Street 1:108 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-4921
Practice Address - Country:US
Practice Address - Phone:410-543-6931
Practice Address - Fax:410-543-6975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD106472OtherMCO AMERIGROUP - BH
MD84-80315OtherMCO UNITED HEALTHCARE-BH
MD705301100OtherMCO-MD PHYS CARE-BH
MD809543OtherMCO PRIORITY PARTNERS-BH
MD523404200Medicaid
MD705301100Medicaid
MD705291000Medicaid
MD809543OtherMCO PRIORITY PARTNERS-BH
MD932142000Medicaid
MD84-80315OtherMCO UNITED HEALTHCARE-BH
MD705291000Medicaid
MD106472OtherMCO AMERIGROUP - BH
MDH939Medicare PIN