Provider Demographics
NPI:1144260894
Name:UNIVERSITY OF MARYLAND MEDICAL CENTER, LLC
Entity type:Organization
Organization Name:UNIVERSITY OF MARYLAND MEDICAL CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRINKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-328-1501
Mailing Address - Street 1:22 SOUTH GREENE STREET
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1544
Mailing Address - Country:US
Mailing Address - Phone:410-328-5233
Mailing Address - Fax:410-328-0666
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:OUT-PATIENT PHARMACY - THE WEINBERG BLDG 1ST FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-1992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-08
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
MDP01661333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD758012600Medicaid
MD0660460001Medicare NSC