Provider Demographics
NPI:1144333923
Name:JOHNS HOPKINS BAYVIEW MEDICAL CENTER, INC.
Entity type:Organization
Organization Name:JOHNS HOPKINS BAYVIEW MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, FINANCE, TREASUER, CFO, JHHS
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:WERTHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-955-6552
Mailing Address - Street 1:P.O. BOX 632064
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21263-2064
Mailing Address - Country:US
Mailing Address - Phone:443-997-0001
Mailing Address - Fax:443-997-0011
Practice Address - Street 1:5505 HOPKINS BAYVIEW CIRCLE
Practice Address - Street 2:JOHNS HOPKINS BAYVIEW CARE CENTER
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224
Practice Address - Country:US
Practice Address - Phone:410-550-0756
Practice Address - Fax:410-550-1190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30086314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD371497700Medicaid
215059Medicare ID - Type Unspecified