1992097521 NPI number — ATLANTIC GENERAL HOSPITAL CORP.

Table of content: (NPI 1992097521)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992097521 NPI number — ATLANTIC GENERAL HOSPITAL CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATLANTIC GENERAL HOSPITAL CORP.
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:
TMC IMAGING
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:
1992097521
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/17/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10026 OLD OCEAN CITY BLVD
Provider Second Line Business Mailing Address:
BUILDING #1
Provider Business Mailing Address City Name:
BERLIN
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21811-1288
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-629-6012
Provider Business Mailing Address Fax Number:
410-641-9515

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 PHILADELPHIA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OCEAN CITY
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21842-3735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-289-6241
Provider Business Practice Location Address Fax Number:
410-289-5533
Provider Enumeration Date:
05/16/2011

Additional Information

Authorized Official

Authorized Official Last Name:
NOTTINGHAM
Authorized Official First Name:
CHERYL
Authorized Official Middle Name:
LEWIS
Authorized Official Title or Position:
VP FINANCE/CFO
Authorized Official Telephone Number:
410-641-9600

Provider Taxonomy Codes

  • Taxonomy code: 261QR0200X , with the licence number:  45-0219 , 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)





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