Provider Demographics
NPI:1083415947
Name:WESTERN MARYLAND HEALTH CARE CORPORATION
Entity type:Organization
Organization Name:WESTERN MARYLAND HEALTH CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:MOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-533-3300
Mailing Address - Street 1:28 HERSHBERGER LN
Mailing Address - Street 2:
Mailing Address - City:GRANTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21536-1172
Mailing Address - Country:US
Mailing Address - Phone:301-895-5107
Mailing Address - Fax:833-448-0359
Practice Address - Street 1:28 HERSHBERGER LN
Practice Address - Street 2:
Practice Address - City:GRANTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21536-1172
Practice Address - Country:US
Practice Address - Phone:301-895-5107
Practice Address - Fax:833-448-0359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy