Provider Demographics
NPI:1326248634
Name:MCCREADY FOUNDATION, INC
Entity Type:Organization
Organization Name:MCCREADY FOUNDATION, INC
Other - Org Name:EDWARD MCCREADY PSYCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PATIENT ACCOUNT MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-968-1200
Mailing Address - Street 1:201 HALL HWY
Mailing Address - Street 2:
Mailing Address - City:CRISFIELD
Mailing Address - State:MD
Mailing Address - Zip Code:21817-1237
Mailing Address - Country:US
Mailing Address - Phone:410-968-1200
Mailing Address - Fax:410-968-1025
Practice Address - Street 1:201 HALL HWY
Practice Address - Street 2:
Practice Address - City:CRISFIELD
Practice Address - State:MD
Practice Address - Zip Code:21817-1237
Practice Address - Country:US
Practice Address - Phone:410-968-1200
Practice Address - Fax:410-968-1025
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCCREADY FOUNDATION, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDK075OtherBLUE SHIELD
MDK075Medicare PIN