Organization
ST. AGNES HEALTHCARE, INC.
Active
Parent organization
ST. AGNES HEALTHCARE, INC.
Other names
St. Agnes Lab Services
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) 234-3060
(667) 234-3572
Mailing address
3585 WASHINGTON BLVD, HALETHORPE, MD 21227-1676
(667) 234-2126
(667) 234-2947
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109948500
—
MD
Enumeration date
06/08/2006
Last updated
02/25/2016
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