1780007443 NPI number — WESTERN MARYLAND PAIN & REHABILITATION CENTER LLC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780007443 NPI number — WESTERN MARYLAND PAIN & REHABILITATION CENTER LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WESTERN MARYLAND PAIN & REHABILITATION CENTER LLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780007443
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1050 W INDUSTRIAL BLVD
Provider Second Line Business Mailing Address:
SUITE 18
Provider Business Mailing Address City Name:
CUMBERLAND
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21502-4331
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-362-7220
Provider Business Mailing Address Fax Number:
240-362-7415

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1050 W INDUSTRIAL BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CUMBERLAND
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21502-4331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-288-3400
Provider Business Practice Location Address Fax Number:
301-624-5393
Provider Enumeration Date:
01/30/2014

Additional Information

Authorized Official

Authorized Official Last Name:
ESKEW
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
202-288-3400

Provider Taxonomy Codes

  • Taxonomy code: 261QP3300X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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