Organization
OWENSVILLE PRIMARY CARE, INC
Active
Parent organization
1225110067
Other names
Bay Community Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
1225110067
Authorized official
CHRISTINA VARGA (REVENUE CYCLE MANAGER)
(410) 867-4700
Entity
Organization
Contact information
Practice address
6131 SHADY SIDE RD, SHADY SIDE, MD 20764-9504
(410) 867-2200
(410) 867-1261
Mailing address
134 OWENSVILLE RD, WEST RIVER, MD 20778-9702
(410) 867-4700
(410) 867-4934
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
LC0431
MD
207Q00000X
Family Medicine Physician
H78924
MD
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
D0038563
MD
2083P0901X
Public Health & General Preventive Medicine Physician
H0076407
MD
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
363A00000X
Physician Assistant
C0003844
MD
363LP2300X
Primary Care Nurse Practitioner
R124971
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103559201
—
MD
05
—
1063914836
—
MD
05
—
209002300
—
MD
05
—
338427600
—
MD
05
—
400629100
—
MD
05
—
404482700
—
MD
05
—
531981100
—
MD
05
—
97991100
—
MD
Enumeration date
07/10/2018
Last updated
09/02/2025
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