Organization
ST. AGNES HOSPICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN CLEMENS (VP OF FINANCE)
(703) 752-8700
Entity
Organization
Contact information
Practice address
1501 S EDGEWOOD ST, SUITE A, BALTIMORE, MD 21227-1071
(410) 368-2825
(410) 368-8449
Mailing address
1501 S EDGEWOOD ST, SUITE A, BALTIMORE, MD 21227-1071
(410) 368-2825
(410) 368-8449
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
H1512
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039395900
—
MD
Enumeration date
07/29/2005
Last updated
02/22/2012
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