Provider Demographics
NPI:1497424238
Name:UPPER CHESAPEAKE MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:UPPER CHESAPEAKE MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:THOMAS AUGUSTUS
Authorized Official - Last Name:PRIOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-643-3344
Mailing Address - Street 1:PO BOX 418670
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-8670
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 UPPER CHESAPEAKE DR
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4324
Practice Address - Country:US
Practice Address - Phone:443-643-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UPPER CHESAPEAKE MEDICAL CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory