Organization
CALVERTHEALTH MEDICAL CENTER, INC.
Active
Parent organization
CALVERT HEALTH SYSTEM, INC.
Other names
CalvertHealth Outpatient Rehabilitation Prince Frederick
Organization subpart
Yes
Provider details
NPI number
Legal business name
CALVERT HEALTH SYSTEM, INC.
Authorized official
DEAN TEAGUE (PRESIDENT/CEO)
(410) 535-8239
Entity
Organization
Contact information
Practice address
130 HOSPITAL RD, SUITE 103, PRINCE FREDERICK, MD 20678-4015
(410) 535-8180
(410) 535-8325
Mailing address
100 HOSPITAL RD, ATT: CONTRACT & CREDENTIALING, PRINCE FREDERICK, MD 20678-4017
(410) 414-4791
(410) 414-4558
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
728804202
—
MD
Enumeration date
05/18/2016
Last updated
01/24/2018
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