| Csu Community Health Center | |
|
2500 W North Ave Suite 131 Baltimore MD 21216-3633 | |
| (410) 951-4188 | |
| Not Available |
| Full Name | Csu Community Health Center |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2500 W North Ave, Baltimore, Maryland |
| Authorized Official Name and Position | Shavon T. Legette (ASSOCIATE DIRECTOR) |
| Authorized Official Contact | 4109514188 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Csu Community Health Center 2601 W. North Avenue Suite 131 Baltimore MD 21216 Ph: (410) 951-4188 | Csu Community Health Center 2500 W North Ave Suite 131 Baltimore MD 21216-3633 Ph: (410) 951-4188 |
| NPI Number | 1427244706 |
|---|---|
| Provider Enumeration Date | 09/19/2007 |
| Last Update Date | 02/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427244706 | NPI | - | NPPES |
| 216200700 | Medicaid | MD | |
| 216500700 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (Maryland) | Primary |
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