| Tri-state Community Health Center-hosp Physicians Practice | |
|
12502 Willowbrook Rd Suite 550, 5th Flr Cumberland MD 21502-6491 | |
| (301) 723-3940 | |
| (301) 723-3941 |
| Full Name | Tri-state Community Health Center-hosp Physicians Practice |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 12502 Willowbrook Rd, Cumberland, Maryland |
| Authorized Official Name and Position | Sheila J Deshong (CHEIF OPERATING OFFICER) |
| Authorized Official Contact | 3016785187 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-state Community Health Center-hosp Physicians Practice 109 Rayloc Dr Hancock MD 21750-1518 Ph: (301) 678-5187 | Tri-state Community Health Center-hosp Physicians Practice 12502 Willowbrook Rd Suite 550, 5th Flr Cumberland MD 21502-6491 Ph: (301) 723-3940 |
| NPI Number | 1801225909 |
|---|---|
| Provider Enumeration Date | 11/08/2013 |
| Last Update Date | 11/08/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801225909 | NPI | - | NPPES |
| 211849 | Other | MD | MEDICARE FQHC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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