Provider Demographics
NPI:1033693551
Name:SHORE HEALTH SYSTEM, INC.
Entity Type:Organization
Organization Name:SHORE HEALTH SYSTEM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KOZEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-822-1000
Mailing Address - Street 1:8221 TEAL DR STE 410
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-7212
Mailing Address - Country:US
Mailing Address - Phone:410-822-1000
Mailing Address - Fax:
Practice Address - Street 1:8221 TEAL DR STE 410
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-7212
Practice Address - Country:US
Practice Address - Phone:410-822-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory