Provider Demographics
NPI:1972900876
Name:WASHINTON COUNTY HEALTH DEPARTMENT WITS
Entity Type:Organization
Organization Name:WASHINTON COUNTY HEALTH DEPARTMENT WITS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL ACCOUNTS CLERK
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARLUP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-313-3492
Mailing Address - Street 1:1302 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-3108
Mailing Address - Country:US
Mailing Address - Phone:240-313-3492
Mailing Address - Fax:
Practice Address - Street 1:740 HOSPITAL WAY
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742
Practice Address - Country:US
Practice Address - Phone:240-313-3322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS285Medicaid