Provider Demographics
NPI: | 1518013093 |
---|---|
Name: | BALTIMORE COUNTY DEPARMENT OF HEALTH |
Entity type: | Organization |
Organization Name: | BALTIMORE COUNTY DEPARMENT OF HEALTH |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KATINA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | PEARCE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 443-809-9409 |
Mailing Address - Street 1: | 6901 N CHARLES ST STE 206 |
Mailing Address - Street 2: | |
Mailing Address - City: | TOWSON |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 21204-3780 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 410-887-3740 |
Mailing Address - Fax: | 410-377-4751 |
Practice Address - Street 1: | 6901 N CHARLES ST |
Practice Address - Street 2: | |
Practice Address - City: | TOWSON |
Practice Address - State: | MD |
Practice Address - Zip Code: | 21204-3780 |
Practice Address - Country: | US |
Practice Address - Phone: | 410-887-3740 |
Practice Address - Fax: | 410-377-4751 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-01-26 |
Last Update Date: | 2025-05-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251K00000X | Agencies | Public Health or Welfare |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MD | 541818600 | Medicaid |