Organization
ST. MARY'S HOSPICE PHYSICIAN - MEDICAID
Active
Organization
ST. MARY'S HOSPICE PHYSICIAN - MEDICAID
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALLAN HALL BURBAGE (DIRECTOR REVENUE CYCLE MANAGEMENT)
(240) 434-7100
Entity
Organization
Contact information
Practice address
22699 WASHINGTON ST., LEONARDTOWN, MD 20650-0650
(301) 475-6438
(301) 475-6188
Mailing address
22699 WASHINGTON ST., LEONARDTOWN, MD 20650-0625
(301) 475-6438
(301) 475-6188
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
H1539
MD
Other
Enumeration date
07/23/2007
Last updated
12/11/2007
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