Provider Demographics
NPI:1639401839
Name:KMH HEALTHCARE CORPORATION
Entity Type:Organization
Organization Name:KMH HEALTHCARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:NEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:KANWAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-564-5227
Mailing Address - Street 1:1498 REISTERSTOWN RD
Mailing Address - Street 2:BOX 364
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3842
Mailing Address - Country:US
Mailing Address - Phone:877-564-5227
Mailing Address - Fax:877-564-3297
Practice Address - Street 1:4000 OLD COURT RD
Practice Address - Street 2:SUITE 103
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-2800
Practice Address - Country:US
Practice Address - Phone:877-564-5227
Practice Address - Fax:877-564-3297
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KMH HEALTHCARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-12
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD199716Medicare PIN