West Cecil Health Center Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Perryville, MD
NPI 1861932089 · NPPES record last updated Mar 7, 2017
Key facts
- NPI
- 1861932089
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- WEST CECIL HEALTH CENTER INC.
- Practice address
- 4863 Pulaski Hwy Ste 200
Perryville, MD 21903-1624 - Phone
- (410) 378-9696
- Fax
- (410) 378-0787
- NPI assigned
- Mar 7, 2017
- Organization subpart
- Yes
- Parent organization (as reported)
- WEST CECIL HEALTH CENTER, INC
Authorized official
- Name
- John Ragnar Ness
- Title
- Interim Ceo/ Cfo
- Phone
- (443) 731-2971
Other NPIs on the same Medicare enrollment 7
Practitioners 4
-
Gemma Melanie Armstrong, D.O.
-
Ruth Laine Scott-Nelson, CRNP-F- PMH
-
Glenn Canares, D.D.S.
-
Chia-Yu Chen, DDS
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140318000266 | MD | Part B Supplier - Clinic/Group Practice | 6709964398 |
Receives reassigned benefits from 24 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Conowingo, MD; Elkton, MD; Havre de Grace, MD |
National Provider Directory
- Part of
- West Cecil Health Center Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
4863 Pulaski Hwy Ste 200
Perryville, MD 21903-1624
Mailing address
PO Box 99
Conowingo, MD 21918-0099
Phone (410) 378-9696
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 414977700 | Medicaid | MD |
Other providers in Perryville, MD
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- Samantha Lynn Webster
- Mary Williams
- Jennifer Wingler
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All providers in Perryville, MD · Federally Qualified Health Center (FQHC) in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.