Provider Demographics
NPI:1336211929
Name:JOHNS HOPKINS HEALTH SYSTEM
Entity Type:Organization
Organization Name:JOHNS HOPKINS HEALTH SYSTEM
Other - Org Name:HOPKINS ELDER PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, FINANCE, TREASURER, CFO, JHHS
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:WERTHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-955-6552
Mailing Address - Street 1:4940 EASTERN AVE
Mailing Address - Street 2:MFL BLDG, 1ST FLOOR, EAST
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-2735
Mailing Address - Country:US
Mailing Address - Phone:443-997-0001
Mailing Address - Fax:443-997-0011
Practice Address - Street 1:4940 EASTERN AVE
Practice Address - Street 2:MFL BLDG, FIRST FLOOR, EAST
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2735
Practice Address - Country:US
Practice Address - Phone:410-550-7044
Practice Address - Fax:410-550-7045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD409642800Medicaid
MD409639800Medicaid
MD1336211929Medicare NSC