Provider Demographics
NPI:1821055393
Name:UPMC WESTERN MARYLAND CORPORATION
Entity Type:Organization
Organization Name:UPMC WESTERN MARYLAND CORPORATION
Other - Org Name:WESTERN MARYLAND HEALTH SYSTEM HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VP CFO
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:R
Authorized Official - Last Name:RUBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-964-8032
Mailing Address - Street 1:1050 W INDUSTRIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-4331
Mailing Address - Country:US
Mailing Address - Phone:240-964-9100
Mailing Address - Fax:240-964-9101
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:240-964-9108
Practice Address - Fax:240-964-8851
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UPMC WESTERN MARYLAND CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-28
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDHH7031251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
229113OtherALLIANCE MAMSI MDIPA OPCH
MD59010101OtherBLUE CROSS
MDMB5OtherBLUE CHOICE FEDERAL
SA7OtherBLUE CHOICE FED
WV0001768001Medicaid
MD000463400Medicaid
MDMB5OtherBLUE CHOICE FEDERAL