THREE LOWER COUNTIES COMMUNITY SERVICES,INC. (NPI# 1407849920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407849920 |
| Entity Type | Organization |
| Organization Name | THREE LOWER COUNTIES COMMUNITY SERVICES,INC. |
| Other Organization Name | CHESAPEAKE HEALTH CARE |
| Practice Address |
12165 Elm St Princess Anne MD 21853-1358 |
| Mailing Address |
Po Box 1978 Salisbury MD 21802-1978 |
| Practice Telephone | 4106515151 |
| Practice Fax Number | 4106514256 |
| Mailing Telephone | 4107491015 |
| Mailing Fax Number | 4107491020 |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2018-09-28 |
| Authorized Official Name | MR. BRIAN E HOLLAND (PRESIDENT & CEO) |
| Authorized Official Telephone | 4107491015 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 119591300 | 05 |
| Other Name | Type Code |
|---|---|
| Chesapeake Health Care | Doing Business As Name - Organization |
| Street Address |
12165 ELM ST |
| City | PRINCESS ANNE |
| State | MD |
| Zip Code | 21853-1358 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164041703 | Roli Emiko | Dentist | 12165 Elm St, Princess Anne, MD 21853-1358 | 2020-04-14 |
| 1013536051 | Antonia Sonte Neal | Student in an Organized Health Care Education/Training Program | 12165 Elm St, Princess Anne, MD 21853-1358 | 2020-04-09 |
| 1821627589 | Michelle Ayoroa-perez | Dentist | 12165 Elm St, Princess Anne, MD 21853-1358 | 2020-04-05 |
| 1649809450 | Surina Das | Student in an Organized Health Care Education/Training Program | 12165 Elm St, Princess Anne, MD 21853-1358 | 2020-04-03 |
| 1578113494 | Remington Charles Glenn Dewey | Dental Hygienist | 12165 Elm St, Princess Anne, MD 21853-1358 | 2019-09-12 |
| 1982259289 | Elisabeth Anne Boyko | Dental Hygienist | 12165 Elm St, Princess Anne, MD 21853-1358 | 2019-08-05 |
| 1790346229 | Jacklyn Aliza Pivovarov | Dentist | 12165 Elm St, Princess Anne, MD 21853-1358 | 2019-06-25 |
| 1023571726 | Jaswinder Singh | Dentist | 12165 Elm St, Princess Anne, MD 21853-1358 | 2019-04-09 |
| 1295298990 | Sukhvir Kaur | Dentist | 12165 Elm St, Princess Anne, MD 21853-1358 | 2019-04-09 |
| 1902368160 | Kiley Amanda Raya | Dentist | 12165 Elm St, Princess Anne, MD 21853-1358 | 2019-04-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205478013 | Zachary Castell | Counselor | 30665 Student Services Center Lane, Princess Anne, MD 21853 | 2019-10-14 |
| 1659798759 | Brittany Leigh Heffernan | Dentist | 12165 Elm Street, Princess Anne, MD 21853 | 2014-03-26 |
| 1750670519 | Earl Gene Grantz | Pharmacist | 1251 Brittingham Lane, Rite Aid Pharmacy, Princess Anne, MD 21853 | 2011-04-01 |
| 1356554018 | Somerset County Health Department | Public Health or Welfare | 11674 Somerset Avenue, Princess Anne, MD 21853 | 2007-05-08 |
| 1801008479 | Cedric Rashaw | Counselor | 1 Umes Backbone Road, Princess Anne, MD 21853 | 2007-05-04 |
| 1053408641 | Nancy V Lorsong | Nurse Practitioner | Backbone Rd, Charles Drew Student Health Center, Princess Anne, MD 21853 | 2006-10-06 |
| 1154354744 | Three Lower Counties Community Services, Inc. | Clinic/Center | 12145 Elm Street, Princess Anne, MD 21853 | 2006-07-08 |
| 1750855797 | Rebecca Coryell | Physician Assistant | 12302 Somerset Ave, Suite A, B, Princess Anne, MD 21853 | 2019-01-13 |
| 1285182857 | Bryant Julian Howard | Social Worker | 12145 Elm St, Princess Anne, MD 21853 | 2016-09-13 |
| 1740490150 | Jon R Spence | Pharmacist | 12145 Elm Street, Princess Anne, MD 21853 | 2007-05-23 |
| Find all providers in zip 21853 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154354744 | Three Lower Counties Community Services, Inc. | Clinic/Center | 12145 Elm Street, Princess Anne, MD 21853 | 2006-07-08 |
| 1881923993 | Three Lower Counties Community Services, Inc. | Clinic/Center | 12165 Elm St, Princess Anne, MD 21853-1358 | 2009-12-18 |
| 1376710111 | Three Lower Counties Community Services, Inc. | Clinic/Center | 12145 Elm St, Princess Anne, MD 21853-1358 | 2008-05-12 |
| 1588831333 | Three Lower Counties Community Services, Inc. | Clinic/Center | 12137 Elm St, Princess Anne, MD 21853-1358 | 2008-05-12 |
| 1184757445 | Three Lower Counties Community Services, Inc. | Clinic/Center | 12145 Elm Street, Princess Anne, MD 21853 | 2007-03-14 |
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|---|---|---|---|---|
| 1528625332 | West Cecil Health Center Inc. | Clinic/Center | 1319 Woodbridge Station Way, Edgewood, MD 21040-3852 | 2019-05-28 |
| 1770044513 | Mobile Medical Care, Inc. | Clinic/Center | 8106 Georgia Ave, Silver Spring, MD 20910-4991 | 2019-03-26 |
| 1013478858 | Mobile Medical Care, Inc. | Clinic/Center | 600 E Gude Dr Bldg A, Rockville, MD 20850-1326 | 2019-03-26 |
| 1326505090 | Community Clinic Inc. | Clinic/Center | 7474 Greenway Center Dr # 300, Greenbelt, MD 20770-3504 | 2019-02-28 |
| 1497222103 | Walnut Street Community Health Center, Inc. | Clinic/Center | 221 E Baltimore St, Hagerstown, MD 21740-6109 | 2018-10-31 |
| 1689160848 | West Cecil Health Center Inc. | Clinic/Center | 200 Road B, Elkton, MD 21921-6695 | 2018-07-10 |
| 1841786001 | West Cecil Health Center Inc. | Clinic/Center | 100 E Bel Air Ave, Aberdeen, MD 21001-3837 | 2018-07-10 |
| 1598251753 | West Cecil Health Center Inc. | Clinic/Center | 233 S Bohemia Ave, Cecilton, MD 21913-1010 | 2018-07-10 |
| 1811403264 | Mary's Center for Maternal and Child Care, Inc- Smart | Clinic/Center | 8910 Riggs Rd, Adelphi, MD 20783-1632 | 2017-12-21 |
| 1669985032 | Choptank Community Health System Inc | Clinic/Center | 21374 Foster Ave, Tilghman, MD 21671-1230 | 2017-11-08 |
| Find all providers with the same taxonomy | ||||
| City | PRINCESS ANNE |
| Zip Code | 21853 |
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| 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.