Three Lower Counties Community Services, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

THREE LOWER COUNTIES COMMUNITY SERVICES, INC.

Practice address

9956 N Main St
Unit# 2
Berlin, MD 21811-1077

Phone

(410) 973-2820

Fax

(410) 973-2843

NPI assigned

Jan 30, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Brian E Holland

Title

President & Ceo

Phone

(410) 749-1015

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538092800000",
    "number": "1285171199",
    "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": "9956 N MAIN ST",
            "address_2": "UNIT# 2",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111077",
            "telephone_number": "410-973-2820",
            "fax_number": "410-973-2843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE LOWER COUNTIES COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-30",
        "last_updated": "2018-09-28",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "410-749-1015",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119591300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Federally Qualified Health Center (FQHC) in Berlin, MD
• Providers in Berlin, MD by specialty
• Federally Qualified Health Center (FQHC) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2018; 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.