Provider Demographics
NPI:1629013982
Name:MERIDIAN HEALTHCARE, INC
Entity Type:Organization
Organization Name:MERIDIAN HEALTHCARE, INC
Other - Org Name:WOODSIDE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DROPESKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-925-4231
Mailing Address - Street 1:101 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3109
Mailing Address - Country:US
Mailing Address - Phone:610-925-4436
Mailing Address - Fax:610-925-4351
Practice Address - Street 1:9101 2ND AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2152
Practice Address - Country:US
Practice Address - Phone:301-588-5544
Practice Address - Fax:301-588-5547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15-006314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
08884OtherAMERIGROUP
MD958100600Medicaid
HU8OtherCAREFIRST - IND/PPO
HU8OtherCAREFIRST - BLUECHOICE
DC019380300Medicaid
71-00317OtherUNITED - EVERCARE
2427134OtherAETNA-HMO
350656OtherUNITED - MAMSI
029SOtherCARE FIRST - PROV/INQ#
DC019380300Medicaid
08884OtherAMERIGROUP
2427134OtherAETNA-HMO
=========OtherCIGNA - MID-ATLANTIC
HU8OtherCAREFIRST - IND/PPO
HU8OtherCAREFIRST - BLUECHOICE
71-00317OtherUNITED - EVERCARE
=========OtherKAISER
=========OtherMARYLAND PHYSICIAN CARE