Provider Demographics
NPI:1407839954
Name:THE CHESTNUT PARTNERSHIP
Entity Type:Organization
Organization Name:THE CHESTNUT PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:D
Authorized Official - Last Name:MERCURIS PENDROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-875-4500
Mailing Address - Street 1:1055 W JOPPA RD
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-3741
Mailing Address - Country:US
Mailing Address - Phone:410-296-2900
Mailing Address - Fax:410-494-8236
Practice Address - Street 1:1055 W JOPPA RD
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-3741
Practice Address - Country:US
Practice Address - Phone:410-296-2900
Practice Address - Fax:410-494-8236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-29
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03-037314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD59016601OtherCAREFIRST BLUECROSS BLUE
MD59016601OtherCAREFIRST BLUECROSS BLUE
MD=========OtherUNITED HEALTHCARE