Provider Demographics
NPI:1952325300
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:2006-07-27
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
MD158504500Medicaid
MD435AHAOtherCAREFIRST OF MD
MDKK25HAOtherCAREFIRST OF MD
MD158504503Medicaid
MDLY77HAOtherCAREFIRST OF MD
MDW609OtherBLUECHOICE
MD158504506Medicaid
MD158504509Medicaid
MDCJ7328OtherRAILROAD MEDICARE
MD158504504Medicaid
MD158504502Medicaid
MD158504507Medicaid
MD158504501Medicaid
MD158504505Medicaid
MD158504508Medicaid
MD158504504Medicaid
MDLY77HAOtherCAREFIRST OF MD