Provider Demographics
NPI:1730293762
Name:THE JOHNS HOPKINS HOSPITAL
Entity Type:Organization
Organization Name:THE JOHNS HOPKINS HOSPITAL
Other - Org Name:JOHNS HOPKINS DIETITIANS AT GREENSPRING
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT, TREASURER, CFO,JHHS
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:WERTHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-955-6552
Mailing Address - Street 1:PO BOX 632049
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21263-2049
Mailing Address - Country:US
Mailing Address - Phone:410-933-1306
Mailing Address - Fax:410-933-1509
Practice Address - Street 1:10755 FALLS ROAD
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4535
Practice Address - Country:US
Practice Address - Phone:410-955-9540
Practice Address - Fax:410-955-0856
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHNS HOPKINS HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-18
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD351841800Medicaid