Provider Demographics
NPI:1427269406
Name:HOSPICE OF QUEEN ANNE'S INC.
Entity type:Organization
Organization Name:HOSPICE OF QUEEN ANNE'S INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:GUERIERI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN,CHPN
Authorized Official - Phone:443-262-4100
Mailing Address - Street 1:255 COMET DRIVE
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21617
Mailing Address - Country:US
Mailing Address - Phone:442-262-4100
Mailing Address - Fax:410-758-5471
Practice Address - Street 1:255 COMET DRIVE
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:MD
Practice Address - Zip Code:21617
Practice Address - Country:US
Practice Address - Phone:442-262-4100
Practice Address - Fax:410-758-5471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH1529251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD111491300Medicaid
MD211529Medicare Oscar/Certification