Choptank Community Health System INC
Clinic/Center, Federally Qualified Health Center (FQHC) in Cambridge, MD. Organization (NPI-2).
NPI number1316617954
StatusActive
Last updated in NPPESSep 15, 2021
Details
- NPI
- 1316617954
- Entity type
- Organization (NPI-2)
- Legal business name
- Choptank Community Health System INC
- Organization subpart
- Yes
- Enumeration date
- Sep 15, 2021
- Certification date
- Sep 1, 2021
- Last updated
- Sep 15, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QF0400X | Clinic/Center, Federally Qualified Health Center (FQHC) | – | – | Yes |
Other names
- St. Clair Head Start Dental Services (Doing Business As)
Practice location
824 Fairmount AveCambridge, MD 21613-2150
Phone 410-479-4306 · Fax 410-479-1714
Mailing address
824 Fairmount AveCambridge, MD 21613-2150
Phone 410-479-4306 · Fax 410-479-1714
Authorized official
Sara Rich
Ceo
4104794306
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