Provider Demographics
NPI:1649270927
Name:VISITING NURSE ASSOCIATION OF MARYLAND, LLC
Entity type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF MARYLAND, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-594-2600
Mailing Address - Street 1:7008 SECURITY BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2566
Mailing Address - Country:US
Mailing Address - Phone:410-594-2600
Mailing Address - Fax:410-594-2570
Practice Address - Street 1:7008 SECURITY BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-2566
Practice Address - Country:US
Practice Address - Phone:410-594-2600
Practice Address - Fax:410-594-2570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-28
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDHH7008251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDHS6OtherBLUE CROSS FEP
MD02GZOtherBLUE CROSS OF MARYLAND
MD410673300Medicaid
217008AMedicare ID - Type Unspecified