Provider Demographics
NPI:1710920053
Name:MERIDIAN HEALTH, INC.
Entity Type:Organization
Organization Name:MERIDIAN HEALTH, INC.
Other - Org Name:SEVERNA PARK 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 1:24 TRUCK HOUSE RD
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-2715
Practice Address - Country:US
Practice Address - Phone:410-544-4220
Practice Address - Fax:410-544-4288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02-019314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
7100066OtherUNITED - AMERICHOICE
HI5OtherCAREFIRST IND/PPO
MD027337600Medicaid
02D2OtherCAREFIRST - PROV/INQ #
181375OtherAETNA- HMO
71-00191OtherUNITED - EVERCARE
240551OtherUNITED - MAMSI
09012OtherAMERIGROUP
HI5OtherCAREFIRST - BLUECHOICE
MD027337600Medicaid
=========OtherJOHNS HOPKINS
=========OtherKAISER
240551OtherUNITED - MAMSI
=========OtherMARYLAND PHYSICIAN CARE
=========OtherHELIXCARE (MEDSTAR)
=========OtherCOVENTRY
=========OtherCAREFIRST - TIN
=========OtherNATIONAL CAPITAL PPO