Organization
WALNUT STREET COMMUNITY HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID F BECKER (CFO)
(301) 745-3777
Entity
Organization
Contact information
Practice address
201 S CLEVELAND AVE, HAGERSTOWN, MD 21740-5745
(301) 745-3777
(301) 393-3428
Mailing address
201 S CLEVELAND AVE, HAGERSTOWN, MD 21740-5745
(301) 745-3777
(301) 393-3459
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
211841
MEDICARE PROVIDER #
MD
Enumeration date
11/23/2005
Last updated
12/05/2023
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