Provider Demographics
NPI:1881683423
Name:MCCREADY FOUNDATION, INC
Entity Type:Organization
Organization Name:MCCREADY FOUNDATION, INC
Other - Org Name:EDWARD MCCREADY MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-968-1200
Mailing Address - Street 1:201 HALL HWY
Mailing Address - Street 2:
Mailing Address - City:CRISFIELD
Mailing Address - State:MD
Mailing Address - Zip Code:21817-1237
Mailing Address - Country:US
Mailing Address - Phone:410-968-1200
Mailing Address - Fax:410-968-1025
Practice Address - Street 1:201 HALL HWY
Practice Address - Street 2:
Practice Address - City:CRISFIELD
Practice Address - State:MD
Practice Address - Zip Code:21817-1237
Practice Address - Country:US
Practice Address - Phone:410-968-1200
Practice Address - Fax:410-968-1025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X, 261QP2300X
MD19-001261QA1903X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Not Answered261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Not Answered261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
Not Answered282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD131292OtherPRIORITY PARTNERS CLINIC
MD110988OtherPRIORITY PARTNERS ANESTH
49827OtherAMERICAID
MD059693OtherPRIORITY PARTNERS OT
MD235089OtherMAMSI
MH236781500Medicaid
VA9805516Medicaid
MD000285200Medicaid
5000064OtherUNITED HEALTH CARE MCO
0126401OtherUNITED HEALTH CARE
1059279OtherKEYSTONE
57350401OtherCAREFIRST BCBS
MC9OtherBCBS NCA
DE000358106Medicaid
MD132748OtherPRIORITY PARTNERS