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Organization

EMERALD HEALTH CENTER, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LUZ J. E. CORREA-CASHDOLLAR R.N. (PRACTICE MANAGER)
(410) 833-0580
Entity
Organization

Contact information

Practice address
217 MAIN ST, REISTERSTOWN, MD 21136-1213
(410) 833-0580
(410) 833-8604
Mailing address
217 MAIN ST, REISTERSTOWN, MD 21136-1213
(410) 833-0580
(410) 833-8604

Taxonomy

Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
D0020136
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
247L
MC GROUP NUMBER
MD
01
KA78EM
CAREFIRST BC/BS
MD
Enumeration date
04/14/2006
Last updated
04/19/2017
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