Provider Demographics
NPI:1669567335
Name:UNION HOSPITAL OF CECIL COUNTY
Entity type:Organization
Organization Name:UNION HOSPITAL OF CECIL COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-620-2685
Mailing Address - Street 1:20 CRAIGTOWN RD
Mailing Address - Street 2:
Mailing Address - City:PORT DEPOSIT
Mailing Address - State:MD
Mailing Address - Zip Code:21904-1801
Mailing Address - Country:US
Mailing Address - Phone:410-398-4000
Mailing Address - Fax:410-620-1493
Practice Address - Street 1:20 CRAIGTOWN RD
Practice Address - Street 2:
Practice Address - City:PORT DEPOSIT
Practice Address - State:MD
Practice Address - Zip Code:21904-1801
Practice Address - Country:US
Practice Address - Phone:410-398-4000
Practice Address - Fax:410-620-1493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07005282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD407431900Medicaid
MDDDP7PEOtherBC MD
MD0004568000OtherBLUE CROSS INDEPENDANCE
DE520607LABOtherBC DE OFF SITE LABS
DE520607RADOtherBC DE OFF SITE RADS
MDFMX002Medicare PIN