Provider Demographics
NPI:1396191458
Name:THE JOHNS HOPKINS HOSPITAL
Entity Type:Organization
Organization Name:THE JOHNS HOPKINS HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP & CFO, JHM
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:WERTHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-288-8022
Mailing Address - Street 1:401 N. BROADWAY, SUITE 1001
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231
Mailing Address - Country:US
Mailing Address - Phone:410-955-5747
Mailing Address - Fax:410-502-1511
Practice Address - Street 1:401 N. BROADWAY, SUITE 1001
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231
Practice Address - Country:US
Practice Address - Phone:410-955-5747
Practice Address - Fax:410-502-1511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-09
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MDP024333336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4125363 00Medicaid
2160284OtherPK