# ST. MARY'S HEALTH DEPARTMENT

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

## Provider details

- **NPI number:** 1508163320
- **Authorized official:** MR. MICHAEL WAYNE BRIDGETT I CRNP (CRNP)
- **Authorized official phone:** (301) 475-4330

## Contact information

- **Practice address:** 21580 PEABODY ST, LEONARDTOWN, MD 20650-2962
- **Practice address phone:** (301) 475-4330
- **Practice address fax:** (301) 475-4383
- **Mailing address:** 21580 PEABODY ST, LEONARDTOWN, MD 20650-2962
- **Mailing address phone:** (301) 475-4330
- **Mailing address fax:** (301) 475-4383

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA0005X | Ambulatory Family Planning Facility | R096847 | MD | Yes |
| 261QC1500X | Community Health Clinic/Center | R096847 | MD | — |

## Other

- **Enumeration date:** 02/14/2011
- **Last updated:** 02/14/2011