Provider Demographics
NPI:1780007443
Name:WESTERN MARYLAND PAIN & REHABILITATION CENTER LLC.
Entity Type:Organization
Organization Name:WESTERN MARYLAND PAIN & REHABILITATION CENTER LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ESKEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-288-3400
Mailing Address - Street 1:1050 W INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE 18
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-4331
Mailing Address - Country:US
Mailing Address - Phone:240-362-7220
Mailing Address - Fax:240-362-7415
Practice Address - Street 1:1050 W INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-4331
Practice Address - Country:US
Practice Address - Phone:202-288-3400
Practice Address - Fax:301-624-5393
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POTOMAC HEALTHCARE ALLIANCE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain