Provider Demographics
NPI:1356554018
Name:SOMERSET COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:SOMERSET COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, APRN/BC, LCADC
Authorized Official - Phone:443-523-1712
Mailing Address - Street 1:8928 SIGN POST ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WESTOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21871
Mailing Address - Country:US
Mailing Address - Phone:443-523-1700
Mailing Address - Fax:410-651-5680
Practice Address - Street 1:11674 SOMERSET AVENUE
Practice Address - Street 2:
Practice Address - City:PRINCESS ANNE
Practice Address - State:MD
Practice Address - Zip Code:21853
Practice Address - Country:US
Practice Address - Phone:443-523-1700
Practice Address - Fax:410-651-5680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDREG #14305 ASAM251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD251269OtherMAMSI
MD705051800Medicaid
MD632504100OtherAPS PROVIDER