NPIMap

Organization Active NPI

Three Lower Counties Community Services, Inc.

Doing business as Chesapeake Health Care

  • Federally Qualified Health Center (FQHC)
  • Princess Anne, MD
National Provider Identifier
1184757445
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
THREE LOWER COUNTIES COMMUNITY SERVICES, INC.
Doing business as
Chesapeake Health Care
Practice address
12145 Elm Street
Princess Anne, MD 21853
Phone
(410) 651-5135
Fax
(410) 651-4682
NPI assigned
Mar 14, 2007
Last updated
Jan 30, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Susanne M. Gray, RN, MSN
Title
President & Ceo
Phone
(410) 749-1015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

12145 Elm Street
Princess Anne, MD 21853

Mailing address

PO Box 1978
Salisbury, MD 21802-1978
Phone (410) 749-1015

Other identifiers 1

IdentifierTypeStateIssuer
119591300MedicaidMD

Other names 1

  • Chesapeake Health Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Abdul K Garuba37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485734400000",
    "number": "1184757445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1978",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218021978",
            "telephone_number": "410-749-1015",
            "fax_number": "410-749-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12145 ELM STREET",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "21853",
            "telephone_number": "410-651-5135",
            "fax_number": "410-651-4682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE LOWER COUNTIES COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2017-01-30",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "SUSANNE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "410-749-1015",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN, MSN"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119591300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chesapeake Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Princess Anne, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.