Provider Demographics
NPI:1417730060
Name:WESTERN MARYLAND HEALTH CARE CORPORATION
Entity type:Organization
Organization Name:WESTERN MARYLAND HEALTH CARE CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-533-3300
Mailing Address - Street 1:22221 WESTERNPORT RD SW
Mailing Address - Street 2:
Mailing Address - City:WESTERNPORT
Mailing Address - State:MD
Mailing Address - Zip Code:21562-2206
Mailing Address - Country:US
Mailing Address - Phone:240-775-2175
Mailing Address - Fax:240-775-8701
Practice Address - Street 1:22221 WESTERNPORT RD SW
Practice Address - Street 2:
Practice Address - City:WESTERNPORT
Practice Address - State:MD
Practice Address - Zip Code:21562-2206
Practice Address - Country:US
Practice Address - Phone:240-775-2175
Practice Address - Fax:240-775-8701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-17
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy