1679609366 NPI number — MAYOR AND CITY COUNCIL OF BALTIMORE

Table of content: (NPI 1679609366)

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:
Provider Other Organization Name Type Code:
6
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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