Organization Name: | GREATER BADEN MEDICAL SERVICE INCORPORATED |
NPI Number: | 1700036183 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SARAH A LEONHARD (EXECUTIVE DIRECTOR) |
Mailing Address: | 13605 Baden Westwood Rd Brandywine |
State: | MD US |
Postal Code: | 206138422 |
Phone Number: | 3018882233 |
Fax Number: | 3018889133 |
NPI Enumeration Date: | 09/23/2008 |
NPI Last Update Date: | 11/24/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |