1083087878 NPI number — MERGENTHALER VOCATIONAL-TECHNICAL HIGH SCHOOL

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083087878 NPI number — MERGENTHALER VOCATIONAL-TECHNICAL HIGH SCHOOL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MERGENTHALER VOCATIONAL-TECHNICAL HIGH SCHOOL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083087878
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
05/13/2023
NPI Reactivation Date:
06/20/2023

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3501 SINCLAIR LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21213-2029
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-703-3658
Provider Business Mailing Address Fax Number:
410-534-2392

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3500 HILLEN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21218-2227
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-703-3663
Provider Business Practice Location Address Fax Number:
443-873-0600
Provider Enumeration Date:
11/03/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SUTTON
Authorized Official First Name:
SHIRLEY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
410-558-4891

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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