Organization
ST. MARY'S NURSING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOIS ANNETTE HODGES (ADMINSTRATOR)
(301) 475-8000
Entity
Organization
Contact information
Practice address
21585 PEABODY STREET, LEONARDTOWN, MD 20650-2955
(301) 475-8000
(301) 475-3085
Mailing address
21585 PEABODY STREET, LEONARDTOWN, MD 20650
(301) 475-8000
(301) 475-3085
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
18002
MD
332BN1400X
Nursing Facility Supplies (DME)
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
695502900
—
MD
Enumeration date
09/09/2005
Last updated
01/05/2016
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