Organization
PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARLENE WHITAKER (REVENUE MANAGER)
(301) 883-7861
Entity
Organization
Contact information
Practice address
1701 MCCORMICK DR, LARGO, MD 20774-5329
(301) 883-7861
(301) 883-7890
Mailing address
1701 MCCORMICK DR, LARGO, MD 20774-5329
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
—
—
1223D0001X
Public Health Dentistry
—
—
163W00000X
Registered Nurse
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083945125
—
MD
05
—
1114155694
—
MD
05
—
1205195013
—
MD
05
—
1366711947
—
MD
05
—
1578821153
—
MD
05
—
1609938992
—
MD
05
—
1871632539
—
MD
05
—
1932254299
—
MD
Enumeration date
03/06/2013
Last updated
03/06/2013
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