Provider Demographics
NPI:1104914464
Name:WAY STATION INC
Entity type:Organization
Organization Name:WAY STATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:KESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-382-8111
Mailing Address - Street 1:230 W PATRICK ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-6945
Mailing Address - Country:US
Mailing Address - Phone:301-662-0099
Mailing Address - Fax:301-694-9932
Practice Address - Street 1:9030 STATE ROUTE 108 STE A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-1990
Practice Address - Country:US
Practice Address - Phone:410-740-1901
Practice Address - Fax:410-740-8932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDK011WAOtherMDBCBS GROUP NUMBER
MDT806OtherBLUE CHOICE GROUP NUMBER
MD264161501Medicaid