Provider Demographics
NPI:1518957141
Name:COMPTROLLER OF MARYLAND CENTRAL PAYROLL BUREAU
Entity Type:Organization
Organization Name:COMPTROLLER OF MARYLAND CENTRAL PAYROLL BUREAU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:WAIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-543-4000
Mailing Address - Street 1:351 DEERS HEAD HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-3201
Mailing Address - Country:US
Mailing Address - Phone:410-543-4000
Mailing Address - Fax:410-543-4004
Practice Address - Street 1:351 DEERS HEAD HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-3201
Practice Address - Country:US
Practice Address - Phone:410-543-4000
Practice Address - Fax:410-543-4004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-25
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22-001281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD352505800Medicaid
MD212003Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
MDK738Medicare ID - Type UnspecifiedMEDICARE PART B PHYSICIAN