1477517225 NPI number — LUMINIS HEALTH ANNE ARUNDEL MEDICAL CENTER, INC.

Table of content: (NPI 1477517225)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477517225 NPI number — LUMINIS HEALTH ANNE ARUNDEL MEDICAL CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LUMINIS HEALTH ANNE ARUNDEL MEDICAL CENTER, INC.
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:
ANNE ARUNDEL MEDICAL CENTER, INC.
Provider Other Organization Name Type Code:
4
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:
1477517225
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/28/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2001 MEDICAL PKWY STE 606
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANNAPOLIS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21401-3773
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-481-1000
Provider Business Mailing Address Fax Number:
443-481-1313

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2001 MEDICAL PARKWAY
Provider Second Line Business Practice Location Address:
HEALTH SCIENCES PAVILION - SUITE 606
Provider Business Practice Location Address City Name:
ANNAPOLIS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-481-1000
Provider Business Practice Location Address Fax Number:
443-481-1313
Provider Enumeration Date:
04/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
REILLY
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
443-481-1308

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  02003/5237 , 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: 904376400 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: HA6 . This is a "GHMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 145724700 . This is a "US DEPT OF LABOR" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 397329 . This is a "FEDERAL BLACK LUNG" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 5000056 . This is a "UHCHMO & UHCMA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 233918 . This is a "MAMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 8204000 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00205400 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2100231 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 885832 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 57639101 . This is a "CAREFIRST BLUE CROSS/SH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 483549 . This is a "NCPPO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 9814108 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 20229100 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".




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