Provider Demographics
NPI:1003972530
Name:JOHNS HOPKINS BAYVIEW MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:JOHNS HOPKINS BAYVIEW MEDICAL CENTER, INC.
Other - Org Name:JOHNS HOPKINS OUTPATIENT PHARMACY AT BAYVIEW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:FRANCIOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-955-6552
Mailing Address - Street 1:PO BOX 418854
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-8854
Mailing Address - Country:US
Mailing Address - Phone:443-997-0001
Mailing Address - Fax:443-997-0011
Practice Address - Street 1:4940 EASTERN AVE
Practice Address - Street 2:BMO BUILDING, ROOM 01-0154
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2735
Practice Address - Country:US
Practice Address - Phone:410-550-0961
Practice Address - Fax:410-550-5566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP020573336C0002X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2112934OtherNCPDP
MD4125355 00Medicaid
MD4131509 00Medicaid
MD0422250003Medicare NSC