Provider Demographics
NPI:1780028647
Name:CHESTER RIVER HOSPITAL CENTER
Entity Type:Organization
Organization Name:CHESTER RIVER HOSPITAL CENTER
Other - Org Name:CHESTER RIVER OUTPATIENT SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-778-3300
Mailing Address - Street 1:100 BROWN ST
Mailing Address - Street 2:
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-1435
Mailing Address - Country:US
Mailing Address - Phone:410-778-3300
Mailing Address - Fax:
Practice Address - Street 1:100 BROWN ST
Practice Address - Street 2:
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-1435
Practice Address - Country:US
Practice Address - Phone:410-778-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHESTER RIVER HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology