Provider Demographics
NPI:1346581550
Name:UNION HOSPITAL OF CECIL COUNTY
Entity Type:Organization
Organization Name:UNION HOSPITAL OF CECIL COUNTY
Other - Org Name:DBA BAINBRIDGE ELEMENTARY SCHOOL SBHC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROXANA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-245-3933
Mailing Address - Street 1:PO BOX 7356
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17604-7356
Mailing Address - Country:US
Mailing Address - Phone:410-398-3686
Mailing Address - Fax:410-392-9289
Practice Address - Street 1:41 PRESTON DR
Practice Address - Street 2:
Practice Address - City:PORT DEPOSIT
Practice Address - State:MD
Practice Address - Zip Code:21904-1800
Practice Address - Country:US
Practice Address - Phone:410-398-3868
Practice Address - Fax:410-392-9289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-13
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty