Provider Demographics
NPI:1952495079
Name:UPMC WESTERN MARYLAND CORPORATION
Entity Type:Organization
Organization Name:UPMC WESTERN MARYLAND CORPORATION
Other - Org Name:UPMC WESTERN MARYLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VP CFO
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-964-8032
Mailing Address - Street 1:PO BOX 1671
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21501-1671
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:301-689-1129
Practice Address - Street 1:10701 NEW GEORGES CREEK RD SW
Practice Address - Street 2:
Practice Address - City:FROSTBURG
Practice Address - State:MD
Practice Address - Zip Code:21532-1457
Practice Address - Country:US
Practice Address - Phone:301-689-3229
Practice Address - Fax:301-689-1129
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UPMC WESTERN MARYLAND CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-03
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKV50FROtherCAREFIRST BC BS
MDCE7390OtherRAILROAD MEDICARE
DCK029OtherBLUE CHOICE
WV0009620000Medicaid
MD608681101Medicaid
DCK029OtherBLUE CHOICE