1356341499 NPI number — GARRETT COUNTY MEMORIAL HOSPITAL

Table of content: (NPI 1356341499)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356341499 NPI number — GARRETT COUNTY MEMORIAL HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GARRETT COUNTY MEMORIAL HOSPITAL
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:
GARRETT REGIONAL MEDICAL CENTER
Provider Other Organization Name Type Code:
3
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:
1356341499
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
251 N FOURTH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKLAND
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21550-1375
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-533-4201
Provider Business Mailing Address Fax Number:
301-533-4208

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
251 N FOURTH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21550-1375
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-533-4201
Provider Business Practice Location Address Fax Number:
301-533-4208
Provider Enumeration Date:
07/29/2005

Additional Information

Authorized Official

Authorized Official Last Name:
LIPSCOMB
Authorized Official First Name:
TRACY
Authorized Official Middle Name:
DAWN
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
301-533-4000

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  11-002 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 59023801 . This is a "CAREFIRST BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 59023801 . This is a "BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000245300 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0006310435 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 59023801 . This is a "B/C CONSOL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 59023801 . This is a "B/C NATIONAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: MA6 . This is a "B/C FEDERAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 59023801 . This is a "TRIGON" identifier . This identifiers is of the category "OTHER".
  • Identifier: 59023801 . This is a "B/C MOUNTAIN STATE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 59023801 . This is a "B/C GENERAL MOTORS" identifier . This identifiers is of the category "OTHER".
  • Identifier: MA6 . This is a "B/C EMPIRE" identifier . This identifiers is of the category "OTHER".
  • Identifier: MA6 . This is a "BC/WV" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 59023801 . This is a "B/C VA POWER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 59023801 . This is a "B/C MD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 59023801 . This is a "HIGHMARK BC/BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 59023801 . This is a "B/C OTHER" identifier . This identifiers is of the category "OTHER".
  • Identifier: MA6 . This is a "B/C MT STATE PEIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 109694600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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