Provider Demographics
NPI:1104077387
Name:LEVINDALE HEBREW GERIATRIC CENTER & HOSPITAL INC.
Entity type:Organization
Organization Name:LEVINDALE HEBREW GERIATRIC CENTER & HOSPITAL INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REHABILITATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:GADSON
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-601-2707
Mailing Address - Street 1:2434 W BELVEDERE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5267
Mailing Address - Country:US
Mailing Address - Phone:410-601-2935
Mailing Address - Fax:410-601-2928
Practice Address - Street 1:2434 W BELVEDERE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5267
Practice Address - Country:US
Practice Address - Phone:410-601-2935
Practice Address - Fax:410-601-2928
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEVINDALE HEBREW GERIATRIC CENTER AND HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-06
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD981002100Medicaid
MD216693Medicare PIN