Provider Demographics
NPI:1942362207
Name:HOSPICE OF GARRETT COUNTY, INC.
Entity Type:Organization
Organization Name:HOSPICE OF GARRETT COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRENNEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-334-5151
Mailing Address - Street 1:203 S SECOND STREET
Mailing Address - Street 2:PO BOX 271
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-2022
Mailing Address - Country:US
Mailing Address - Phone:301-334-5151
Mailing Address - Fax:301-334-5800
Practice Address - Street 1:203 S 2ND ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-1551
Practice Address - Country:US
Practice Address - Phone:301-334-5151
Practice Address - Fax:301-334-5800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH1535251G00000X
251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD113500703Medicaid
MDMH1OtherFEDERAL BCBS
MD57814701OtherCAREFIRST BCBS