Organization Name: | CORRECTIONAL MEDICAL SERVICES |
NPI Number: | 1093946709 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ASRESAHEGN GETACHEW (STATEWIDE MEDICAL DIRECTOR) |
Mailing Address: | 7943 Brock Bridge Rd Jessup |
State: | MD US |
Postal Code: | 207949704 |
Phone Number: | 4103793873 |
Fax Number: | |
NPI Enumeration Date: | 07/29/2009 |
NPI Last Update Date: | 07/30/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2400X |
License Number: | D0058537 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Prison Health |
Taxonomy Definition: |