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ST. MARY'S HEALTH DEPARTMENT NPI 1508163320


NPI Information

NPI: 1508163320
Provider Name: ST. MARY'S HEALTH DEPARTMENT
Classification: Clinic/Center - 261QA0005X
Entity Type: Organization

Specialization: Ambulatory Family Planning Facility

CLIA Number: 21D1013170

Address:
21580 PEABODY ST
LEONARDTOWN, MD
ZIP 20650
Phone: (301) 475-4330
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ST. MARY'S HEALTH DEPARTMENT is an ambulatory family planning facility clinic center in Leonardtown, MD. The provider is an abortion/family planning facility where services are provided at a fixed specific location. An Ambulatory Family Planning Facility does not provide overnight accommodations. The following procedures may be performed at an Ambulatory Family Planning Facility: abortions, laproscopy, hysterectomies, tubule ligation and other related procedures. Abortion is considered voluntary termination of pregnancy. ST. MARY'S HEALTH DEPARTMENT NPI is 1508163320. The provider is registered as an organization entity type.

The provider's business location address is:

21580 PEABODY ST
LEONARDTOWN, MD
ZIP 20650-962
Phone: (301) 475-4330
Fax: (301) 475-4383

The provider's authorized official is Michael Wayne Bridgett .
The authorized official title is Crnp and has the following contact phone number (301) 475-4330.

The CLIA number assigned to this NPI record is 21D1013170 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/14/2011 and was last updated on 2/14/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QC1500XClinic/CenterCommunity HealthR096847MARYLANDNo
2261QA0005XClinic/CenterAmbulatory Family Planning FacilityR096847MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1=========MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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