Provider Demographics
NPI:1952338964
Name:DEERS HEAD HOSPITAL CENTER
Entity Type:Organization
Organization Name:DEERS HEAD HOSPITAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:KEEFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-543-4033
Mailing Address - Street 1:351 DEERS HEAD HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-3201
Mailing Address - Country:US
Mailing Address - Phone:410-543-4000
Mailing Address - Fax:410-543-4110
Practice Address - Street 1:351 DEERS HEAD HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-3201
Practice Address - Country:US
Practice Address - Phone:410-543-4000
Practice Address - Fax:410-543-4110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22-004314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD446891100Medicaid