Provider Demographics
NPI:1912329434
Name:UNIVERSITY OF MARYLAND MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:UNIVERSITY OF MARYLAND MEDICAL CENTER, LLC
Other - Org Name:UMMS PHARMACY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRINKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-328-1501
Mailing Address - Street 1:920 ELKRIDGE LANDING RD
Mailing Address - Street 2:SUITE 1W111
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090
Mailing Address - Country:US
Mailing Address - Phone:855-547-4276
Mailing Address - Fax:410-684-3776
Practice Address - Street 1:920 ELKRIDGE LANDING RD
Practice Address - Street 2:SUITE 1W111
Practice Address - City:LINTHICUM
Practice Address - State:MD
Practice Address - Zip Code:21090-2917
Practice Address - Country:US
Practice Address - Phone:855-547-4276
Practice Address - Fax:410-684-3776
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-17
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
MDP062363336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD422512100Medicaid
MD422512100Medicaid