PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT (NPI# 1194213728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194213728 |
| Entity Type | Organization |
| Organization Name | PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT |
| Other Organization Name | PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT-SBW-BLADENSBURG |
| Practice Address |
4200 57th Ave Bladensburg MD 20710-1710 |
| Mailing Address |
1701 Mccormick Dr Ste 120 Largo MD 20774-5329 |
| Practice Telephone | 2406963356 |
| Practice Fax Number | 3018837890 |
| Mailing Telephone | 3018837822 |
| Mailing Fax Number | 3018837890 |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2020-09-17 |
| Authorized Official Name | TAMALA BUTLER (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 3018837822 |
| Is Organization Subpart | Y |
| Parent Organization Name | PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QA0000X |
Family Medicine Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 261QS1000X |
Clinic/Center Specialization: Student Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Prince George's County Health Department-SBW-Bladensburg | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083102438 | Prince George's County Health Department | Family Medicine | 6701 Leyte Drive, Oxon Hill, MD 20745 | 2018-05-01 |
| 1265920615 | Prince George's County Health Department | Clinic/Center | 6501 Columbia Park Rd, Hyattsville, MD 20785-3970 | 2018-05-01 |
| 1457849093 | Prince George's County Health Department | Clinic/Center | 7000 Adelphi Road, Hyattsville, MD 20782 | 2018-04-30 |
| 1205262771 | Prince George's County Health Department | Clinic/Center | 3003 Hospital Dr Ste 1055, Cheverly, MD 20785-1194 | 2013-09-17 |
| 1083945125 | Prince George's County Health Department | Community/Behavioral Health | 3003 Hospital Drive - Ground Floor, Cheverly, MD 20785 | 2010-01-28 |
| 1114155694 | Prince George's County Health Department | Dentist | 3003 Hospital Dr Ste 1048, Cheverly, MD 20785-1194 | 2009-06-23 |
| 1447456751 | Prince George's County Health Department | Public Health or Welfare | 6701 Leyte Dr, Oxon Hill, MD 20745-2110 | 2007-06-23 |
| 1548487820 | Prince George's County Health Department | Public Health or Welfare | 1801 Mccormick Dr Fl 2, Largo, MD 20774-5326 | 2007-04-19 |
| 1871632539 | Prince George's County Health Department | Public Health or Welfare | 9314 Piscataway Road, Clinton, MD 20735-3630 | 2007-02-06 |
| 1023091915 | Prince George's County Health Department | Public Health or Welfare | 1701 Mccormick Dr, Largo, MD 20774-5329 | 2005-11-23 |
| Street Address |
4200 57TH AVE |
| City | BLADENSBURG |
| State | MD |
| Zip Code | 20710-1710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649745969 | Kudirat Yusuf | Registered Nurse | 5106 Upshur St, Bladensburg, MD 20710 | 2018-10-12 |
| 1083100903 | Solange Lum Ngwa | Home Health | 3801 Kenilworth Ave Apt 401e, Bladensburg, MD 20710 | 2018-07-03 |
| 1093215816 | Bilikis Adejoke Bello I | Home Health Aide | 4265 58th Ave Apt T1, Bladensburg, MD 20710 | 2018-02-19 |
| 1689047409 | Lifeline Incoporation | Custodial Care Facility | 502 Varnum Street, Bladensburg, MD 20710 | 2015-11-02 |
| 1881016376 | Emmanuel Achaleke | Student in an Organized Health Care Education/Training Program | 5800 Annapolis Road, Apartment 807, Bladensburg, MD 20710 | 2014-01-17 |
| 1912338716 | Omoseke Olasesan | Home Health Aide | 5006 57th Ave, Bladensburg, MD 20710 | 2013-12-03 |
| 1629400171 | Okechukwu N Emmanuel | Home Health Aide | 5030 57th Ave Apt 201, Bladensburg, MD 20710 | 2013-08-07 |
| 1831534775 | Idowu Ojo | Home Health Aide | 5202 Varunm St, Bladensburg, MD 20710 | 2013-05-06 |
| 1558609479 | Osman Tot Kamara | Home Health Aide | 4319 57th Ave Apt 10, Bladensburg, MD 20710 | 2013-01-28 |
| 1659636942 | Afoussath Amoussa | Home Health Aide | 5021 Townsend Way, A3, Bladensburg, MD 20710 | 2012-07-12 |
| Find all providers in zip 20710 | ||||
| Taxonomy Code | 261QS1000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Student Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417519414 | Howard County Health Department | Clinic/Center | Cradlerock Elementary School-based Wellness Center, 6700 Cradlerock Way, Columbia, MD 21045 | 2019-07-01 |
| 1689168452 | Howard County Health Department | Clinic/Center | 7030 Banbury Dr, Hanover, MD 21076-2101 | 2018-06-15 |
| 1457849093 | Prince George's County Health Department | Clinic/Center | 7000 Adelphi Road, Hyattsville, MD 20782 | 2018-04-30 |
| 1508386079 | Howard County Health Department | Clinic/Center | 5460 Trumpeter Road, Hchd Wilde Lake High School-based Wellness Center, Columbia, MD 21044-2314 | 2017-06-26 |
| 1174043640 | Howard County Health Department | Clinic/Center | 6925 Old Waterloo Road, Hchd Deep Run Elementary School-based Wellness Center, Elkridge, MD 21075 | 2017-06-26 |
| 1730632746 | Howard County Health Department | Clinic/Center | 9151 Vollmerhausen Rd, Jessup, MD 20794-9517 | 2016-07-26 |
| 1396127411 | Manan Harshadray Patel | Clinic/Center | 650 W Baltimore St Dept Of, Baltimore, MD 21201-1510 | 2015-06-25 |
| 1154751584 | Morgan State University Health Center | Clinic/Center | 1700 E Cold Spring Ln, Baltimore, MD 21251-0001 | 2013-11-21 |
| 1457784399 | Baltimore County Maryland | Clinic/Center | 1701 Delvale Ave, Baltimore, MD 21222-1235 | 2013-08-14 |
| 1053753616 | Bollman Bridge Elementary School-based Wellness Center | Clinic/Center | 8200 Savage-guilford Road, Jessup, MD 20794 | 2013-07-24 |
| Find all providers with the same taxonomy | ||||
| City | BLADENSBURG |
| Zip Code | 20710 |
Please comment or provide details below to improve the information on PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.