Organization
PARK WEST HEALTH SYSTEM, INC.
Active
Other names
Howard Park Community Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH LEE (CFO)
(410) 542-7800
Entity
Organization
Contact information
Practice address
4601 LIBERTY HEIGHTS AVE, BALTIMORE, MD 21207-7553
(443) 884-7577
(667) 239-3121
Mailing address
4601 LIBERTY HEIGHTS AVE, BALTIMORE, MD 21207-7553
(410) 542-7800
(410) 542-3014
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
912391100
—
MD
Enumeration date
09/08/2014
Last updated
11/03/2014
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