Provider Demographics
NPI:1659964344
Name:STATE OF MARLYAND
Entity Type:Organization
Organization Name:STATE OF MARLYAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, OPERATIONAL SERVICES ADMI
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:FRENCH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:410-537-3138
Mailing Address - Street 1:1800 WASHINGTON BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-1718
Mailing Address - Country:US
Mailing Address - Phone:410-537-3138
Mailing Address - Fax:
Practice Address - Street 1:1800 WASHINGTON BOULEVARD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-1718
Practice Address - Country:US
Practice Address - Phone:410-537-3138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STATE OF MARYLAND
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare