Provider Demographics
NPI:1679541460
Name:ANNE ARUNDEL MEDICAL CENTER INC
Entity Type:Organization
Organization Name:ANNE ARUNDEL MEDICAL CENTER INC
Other - Org Name:ANNE ARUNDEL MEDICAL CENTER SURGICAL HOSPITALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-481-6558
Mailing Address - Street 1:PO BOX 64834
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4834
Mailing Address - Country:US
Mailing Address - Phone:443-481-6573
Mailing Address - Fax:443-481-6515
Practice Address - Street 1:2001 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3280
Practice Address - Country:US
Practice Address - Phone:443-481-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-09
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
K585OtherCAREFIRST
145726104OtherDEPT OF LABOR
MD936200201Medicaid
2464673OtherAETNA
887BAAOtherCAREFIRST
K585OtherCAREFIRST
145726104OtherDEPT OF LABOR
=========01OtherHEALTH NET FEDERAL SERVICES