Provider Demographics
NPI:1114924453
Name:CARROLL HOSPITAL CENTER, INC
Entity Type:Organization
Organization Name:CARROLL HOSPITAL CENTER, INC
Other - Org Name:CARROLL HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VICE PRESIDENT, FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-848-3000
Mailing Address - Street 1:292 STONER AVE
Mailing Address - Street 2:CARROLL HOSPITAL CENTER
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-4847
Mailing Address - Country:US
Mailing Address - Phone:410-871-8000
Mailing Address - Fax:410-871-7216
Practice Address - Street 1:292 STONER AVE
Practice Address - Street 2:CARROLL HOSPITAL CENTER
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-4847
Practice Address - Country:US
Practice Address - Phone:410-871-8000
Practice Address - Fax:410-871-7216
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1912904210
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-01
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDHH 7144251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD409269400Medicaid
MD409269400Medicaid