1679609366 NPI number — MAYOR AND CITY COUNCIL OF BALTIMORE

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 1679609366 NPI number — MAYOR AND CITY COUNCIL OF BALTIMORE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MAYOR AND CITY COUNCIL OF BALTIMORE
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:
BALTIMORE CITY FIRE DEPARTMENT
Provider Other Organization Name Type Code:
5
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:
1679609366
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/03/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 62826
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:
21264-2826
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-447-8906
Provider Business Mailing Address Fax Number:
914-741-1325

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 E FAYETTE ST
Provider Second Line Business Practice Location Address:
LOWER LEVEL 1
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21202-3426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-396-3092
Provider Business Practice Location Address Fax Number:
443-984-5011
Provider Enumeration Date:
02/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FISCHER
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CHIEF OF FISCAL SERVICES
Authorized Official Telephone Number:
410-396-3092

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  D0037818 , 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: 590005464 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 9228004 00 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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