Provider Demographics
NPI:1174660120
Name:UNIVERSITY OF MARYLAND MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:UNIVERSITY OF MARYLAND MEDICAL CENTER, LLC
Other - Org Name:UNIVERSITY OF MARYLAND MEDICAL CENTER
Other - Org Type:Doing Business As
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 1:11311 MCCORMICK RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031-1004
Mailing Address - Country:US
Mailing Address - Phone:410-821-4140
Mailing Address - Fax:410-821-4189
Practice Address - Street 1:22 S GREENE STREET
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201
Practice Address - Country:US
Practice Address - Phone:410-328-8667
Practice Address - Fax:410-821-4189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30068282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD521362793OtherEHP
MD521362793OtherAMALGAMATED
MD57710801OtherBC OUT OF STATE
MD57710801OtherBC MAGELLAN
MD340925200Medicaid
MD521362793OtherAPS HEALTHCARE
MD521362793OtherCAREFIRST ADMINISTRATORS
MD57710801OtherBC NASCO
MDMC6OtherBCBS CAPITAL CARE
MD521362793OtherAETNA
MD521362793OtherCORESOURCE
MD57710801OtherBC OF MARYLAND
MD521362793OtherCONSTRUCTION WORKERS
MD521362793OtherCIGNA
MD521362793OtherELECTRICAL WORKERS
MD521362793OtherAUTO ACCIDENT
MD218212OtherALLIANCE PPO
MDMC6OtherBC FEDERAL PROGRAM
MDMC6OtherBLUE CHOICE BLUE PREFERRE
MD=========OtherELECTRICAL WORKERS