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Contact Information

ANTIETAM FAMILY HEALTH, LLC
221 E BALTIMORE ST
HAGERSTOWN, MD21740-6109
 Phone: 240-203-8864
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for ANTIETAM FAMILY HEALTH, LLC

NPI Number 1003693102
LBN Legal business name ANTIETAM FAMILY HEALTH, LLC
Authorized official MARK RONCONE - (OWNER/PROVIDER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/12/2023
Last updated 09/12/2023 - About 3 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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