Organization
HEALTHPORT
Active
Other names
Lower Shore Clinic, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINE GARTLITZ (VICE PRESIDENT)
(410) 202-2651
Entity
Organization
Contact information
Practice address
505 E MAIN ST, SALISBURY, MD 21804
(410) 341-3420
(410) 341-3397
Mailing address
208 E MAIN ST STE C, SALISBURY, MD 21801-4923
(410) 341-3420
(410) 341-3397
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
298470900
—
MD
01
—
LS92
BLUE CROSS BLUE SHIELD MD
MD
Enumeration date
07/18/2005
Last updated
03/04/2025
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