Provider Demographics
NPI:1831237684
Name:UNIVERSITY SPECIALTY HOSPITAL
Entity type:Organization
Organization Name:UNIVERSITY SPECIALTY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT & CFD
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-328-3276
Mailing Address - Street 1:1301 YORK ROAD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093
Mailing Address - Country:US
Mailing Address - Phone:410-821-4162
Mailing Address - Fax:410-821-4189
Practice Address - Street 1:611 SOUTH CHARLES STREET
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230
Practice Address - Country:US
Practice Address - Phone:410-547-8500
Practice Address - Fax:410-821-4189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30075282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD57390801OtherBC OF MARYLAND
MD57390801OtherBC NASCO
MD00825700Medicaid
MD57390801OtherBC OUT OF STATE
MDNK7OtherBLUE CHOICE BLUE PREFERRE
MDNK7OtherBC FEDERAL PROGRAM
MD57390801OtherBC OF MARYLAND
MD=========OtherAETNA
MD57390801OtherBC OUT OF STATE