Provider Demographics
NPI:1831110873
Name:HARBOR HOSPITAL
Entity Type:Organization
Organization Name:HARBOR HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:A.V.P
Authorized Official - Prefix:
Authorized Official - First Name:GOVIND
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHESHWARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-350-3636
Mailing Address - Street 1:3001 S HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21225-1233
Mailing Address - Country:US
Mailing Address - Phone:410-350-3200
Mailing Address - Fax:
Practice Address - Street 1:3001 S HANOVER ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21225-1233
Practice Address - Country:US
Practice Address - Phone:410-350-3200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD529507600Medicaid
MD471001100Medicaid
MD14ZBOtherCAREFIRST OF MD
MD435AHAOtherCAREFIRST OF MD
MDKK25HAOtherCAREFIRST OF MD
MD529507602Medicaid
MD529507601Medicaid
MDCC0990OtherRAILROAD MEDICARE
MD529507601Medicaid
MD529507602Medicaid