Provider Demographics
NPI:1477517225
Name:LUMINIS HEALTH ANNE ARUNDEL MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:LUMINIS HEALTH ANNE ARUNDEL MEDICAL CENTER, INC.
Other - Org Name:ANNE ARUNDEL MEDICAL CENTER, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:REILLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-481-1308
Mailing Address - Street 1:2001 MEDICAL PKWY STE 606
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3773
Mailing Address - Country:US
Mailing Address - Phone:443-481-1000
Mailing Address - Fax:443-481-1313
Practice Address - Street 1:2001 MEDICAL PARKWAY
Practice Address - Street 2:HEALTH SCIENCES PAVILION - SUITE 606
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401
Practice Address - Country:US
Practice Address - Phone:443-481-1000
Practice Address - Fax:443-481-1313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02003/5237282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL904376400Medicaid
MDHA6OtherGHMSI
MD145724700OtherUS DEPT OF LABOR
MD397329OtherFEDERAL BLACK LUNG
MD5000056OtherUHCHMO & UHCMA
MD233918OtherMAMSI
PA8204000Medicaid
MD00205400Medicaid
VA2100231Medicaid
OH885832Medicaid
MD57639101OtherCAREFIRST BLUE CROSS/SH
MD483549OtherNCPPO
WV9814108Medicaid
DC20229100Medicaid
MDHA6OtherGHMSI