Provider Demographics
NPI:1881799344
Name:BALTIMORE WASHINGTON MEDICAL CENTER INC.
Entity type:Organization
Organization Name:BALTIMORE WASHINGTON MEDICAL CENTER INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PAESCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-787-4879
Mailing Address - Street 1:301 HOSPITAL DR
Mailing Address - Street 2:SUITE 801
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5803
Mailing Address - Country:US
Mailing Address - Phone:410-553-8290
Mailing Address - Fax:410-553-8288
Practice Address - Street 1:301 HOSPITAL DR
Practice Address - Street 2:SUITE 801
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5803
Practice Address - Country:US
Practice Address - Phone:410-553-8290
Practice Address - Fax:410-553-8288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4685650001Medicare NSC