1336145127 NPI number — FREDERICK HEALTH HOSPITAL INC

Table of content: (NPI 1336145127)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336145127 NPI number — FREDERICK HEALTH HOSPITAL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FREDERICK HEALTH HOSPITAL 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:
FMH ROSE HILL REHAB, MT. AIRY REHAB, CRESTWOOD REHAB. MT. AIRY HEALTH
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:
1336145127
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
400 W 7TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREDERICK
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21701-4506
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-566-3330
Provider Business Mailing Address Fax Number:
240-566-4872

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
163 THOMAS JOHNSON DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREDERICK
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21702-4673
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-566-3132
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/27/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BOGGS
Authorized Official First Name:
SHELBY
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
443-721-4452

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225XH1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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