Provider Demographics
NPI:1891486908
Name:UPPER CHESAPEAKE MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:UPPER CHESAPEAKE MEDICAL CENTER, INC.
Other - Org Name:UM CHESAPEAKE BEHAVIORAL HEALTH PAVILION AT ABERDEEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:THOMAS AUGUSTUS
Authorized Official - Last Name:PRIOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-643-3344
Mailing Address - Street 1:660 MCHENRY RD
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:660 MCHENRY RD
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001
Practice Address - Country:US
Practice Address - Phone:443-843-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Yes283Q00000XHospitalsPsychiatric Hospital