Organization
CIVISTA MEDICAL CENTER, INC.
Active
Other names
University of Maryland Charles Regional Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT ZANGER (CFO)
(301) 609-5163
Entity
Organization
Contact information
Practice address
5 GARRETT AVE, LA PLATA, MD 20646-5960
(301) 609-4000
(301) 609-4411
Mailing address
PO BOX 1070, LA PLATA, MD 20646-1070
(301) 609-5163
(301) 934-0053
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
05/21/2021
Last updated
05/21/2021
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