| Organization Name: | PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT |
| NPI Number: | 1023091915 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GWENDOLYN T. CLERKLEY (ACTING HEALTH OFFICER) |
| Mailing Address: | 1701 Mccormick Dr Largo |
| State: | MD US |
| Postal Code: | 207745329 |
| Phone Number: | 3018837819 |
| Fax Number: | 3018837890 |
| NPI Enumeration Date: | 11/23/2005 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |