Provider Demographics
NPI:1942290077
Name:MERITUS MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:MERITUS MEDICAL CENTER, INC.
Other - Org Name:MERITUS HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR HOME HEALTH CARE
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:TRITAPOE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, RRT
Authorized Official - Phone:301-766-7800
Mailing Address - Street 1:1799 HOWELL RD
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6638
Mailing Address - Country:US
Mailing Address - Phone:301-766-7800
Mailing Address - Fax:301-766-7830
Practice Address - Street 1:1799 HOWELL RD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6638
Practice Address - Country:US
Practice Address - Phone:301-766-7800
Practice Address - Fax:301-766-7830
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERITUS MEDICAL CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-28
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDHH7085251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD353323900Medicaid
217085Medicare PIN