Provider Demographics
NPI:1780284448
Name:FREDERICK HEALTH HOSPITAL INC
Entity type:Organization
Organization Name:FREDERICK HEALTH HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. VP AND CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:K
Authorized Official - Last Name:MAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-566-3337
Mailing Address - Street 1:1 FREDERICK HEALTH WAY
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-9435
Mailing Address - Country:US
Mailing Address - Phone:240-566-3222
Mailing Address - Fax:240-566-3961
Practice Address - Street 1:1 FREDERICK HEALTH WAY
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-9435
Practice Address - Country:US
Practice Address - Phone:240-566-3222
Practice Address - Fax:240-566-3961
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FREDERICK HEALTH HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion