1831237684 NPI number — UNIVERSITY SPECIALTY HOSPITAL

Table of content: (NPI 1831237684)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831237684 NPI number — UNIVERSITY SPECIALTY HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY SPECIALTY 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:
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:
1831237684
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1301 YORK ROAD
Provider Second Line Business Mailing Address:
SUITE 600
Provider Business Mailing Address City Name:
LUTHERVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21093
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-821-4162
Provider Business Mailing Address Fax Number:
410-821-4189

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
611 SOUTH CHARLES STREET
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:
21230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-547-8500
Provider Business Practice Location Address Fax Number:
410-821-4189
Provider Enumeration Date:
02/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FRANEY
Authorized Official First Name:
HENRY
Authorized Official Middle Name:
Authorized Official Title or Position:
SENIOR VICE PRESIDENT & CFD
Authorized Official Telephone Number:
410-328-3276

Provider Taxonomy Codes

  • Taxonomy code: 282E00000X , with the licence number:  30075 , 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: 57390801 . This is a "BC OF MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 57390801 . This is a "BC NASCO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 00825700 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 57390801 . This is a "BC OUT OF STATE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: NK7 . This is a "BLUE CHOICE BLUE PREFERRE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: NK7 . This is a "BC FEDERAL PROGRAM" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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