# PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356218218
- **Authorized official:** TAMALA VICKS (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (240) 302-8576

## Contact information

- **Practice address:** 7 REDLEAF ROSE CT, REISTERSTOWN, MD 21136-6046
- **Practice address phone:** (301) 883-7879
- **Mailing address:** 1701 MCCORMICK DR, LARGO, MD 20774-5329

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174H00000X | Health Educator | — | NULL | Yes |
| 174H00000X | Health Educator | — | — | Yes |

## Other

- **Enumeration date:** 10/23/2025
- **Last updated:** 12/16/2025