| West Cecil Health Center Inc. | |
|
4863 Pulaski Hwy Ste 200 Perryville MD 21903-1624 | |
| (410) 378-9696 | |
| (410) 378-0787 |
| Full Name | West Cecil Health Center Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 4863 Pulaski Hwy Ste 200, Perryville, Maryland |
| Authorized Official Name and Position | John Ragnar Ness (INTERIM CEO/ CFO) |
| Authorized Official Contact | 4437312971 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Cecil Health Center Inc. Po Box 99 Conowingo MD 21918-0099 Ph: (410) 378-9696 | West Cecil Health Center Inc. 4863 Pulaski Hwy Ste 200 Perryville MD 21903-1624 Ph: (410) 378-9696 |
| NPI Number | 1861932089 |
|---|---|
| Provider Enumeration Date | 03/07/2017 |
| Last Update Date | 03/07/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861932089 | NPI | - | NPPES |
| 414977700 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Sokoloff Management, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1001 Cedar Corner Rd Ste B, Perryville, MD 21903 Phone: 410-942-9552 Fax: 410-942-9509 |