Family Health Centers of Baltimore, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

FAMILY HEALTH CENTERS OF BALTIMORE, INC.

Practice address

3540 S Hanover St
Brooklyn, MD 21225-1732

Phone

(410) 355-0343

Fax

(410) 355-5764

NPI assigned

Jan 23, 2008

Last updated

Mar 20, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Paula B McLellan

Title

Ceo

Phone

(410) 354-2001

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Family Health Centers of Baltimore

  • Federally Qualified Health Center (FQHC)
  • Baltimore, MD
  • NPI 1346286713

  O20040126000215

  Same enrollment
• Family Health Centers of Baltimore, Inc.

  • Federally Qualified Health Center (FQHC)
  • Baltimore, MD
  • NPI 1205013539

  O20040126000215

  Same enrollment

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395273600000",
    "number": "1336326248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 CHERRY HILL RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212251228",
            "telephone_number": "410-354-2000",
            "fax_number": "410-354-3674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 S HANOVER ST",
            "city": "BROOKLYN",
            "state": "MD",
            "postal_code": "212251732",
            "telephone_number": "410-355-0343",
            "fax_number": "410-355-5764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTERS OF BALTIMORE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-23",
        "last_updated": "2014-03-20",
        "status": "A",
        "authorized_official_last_name": "MCLELLAN",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-354-2001",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Tamader H. Mira, P.a.
• Gabrielle Drenner
• Shamonique Driskell, LCPC
• Shanu Eapen, PHARM D
• Eastern Pharmaceuticals (MedMerica Discount Pharmacy)
• Richard Ernest Fisher, M.D.
• Pamela Recella Garcia, RPT
• Genesis Rehab Services
• Leo Gorner, PT
• Connie Aurnette Hall

• Federally Qualified Health Center (FQHC) in Brooklyn, MD
• Providers in Brooklyn, 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 Mar 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.