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Organization
ST. AGNES HEALTHCARE, INC.
Active
Organization
ST. AGNES HEALTHCARE, INC.
Active
Parent organization
ST. AGNES HEALTHCARE, INC.
Other names
St. Agnes Diabetes
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. AGNES HEALTHCARE, INC.
Authorized official
MR. KEITH VANDER KOLK (PRESIDENT/CEO)
(667) 234-2101
Entity
Organization
Contact information
Practice address
900 CATON AVE, BALTIMORE, MD 21229-5201
(667) 234-8448
(667) 234-2429
Mailing address
3585 WASHINGTON BLVD, HALETHORPE, MD 21227-1676
(667) 234-2149
(667) 234-8644
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
09/23/2014
Last updated
02/25/2016
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