Provider Demographics
NPI:1831645639
Name:WASHINGTON COUNTY HEALTH DEPARTMENT-CENTRAL35
Entity Type:Organization
Organization Name:WASHINGTON COUNTY HEALTH DEPARTMENT-CENTRAL35
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:STONER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-313-3436
Mailing Address - Street 1:1302 PENNYSLVANIA AVENUE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742
Mailing Address - Country:US
Mailing Address - Phone:240-313-3492
Mailing Address - Fax:
Practice Address - Street 1:925 N BURHANS BLVD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-3173
Practice Address - Country:US
Practice Address - Phone:240-313-3310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS285Medicaid