Provider Demographics
NPI:1699286401
Name:SHORE HEALTH SYSTEM INC
Entity type:Organization
Organization Name:SHORE HEALTH SYSTEM INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:D
Authorized Official - Last Name:KOZEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-822-1000
Mailing Address - Street 1:10 MARTIN CT STE 100
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-4095
Mailing Address - Country:US
Mailing Address - Phone:410-820-7778
Mailing Address - Fax:410-820-8862
Practice Address - Street 1:10 MARTIN CT STE 100
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-4095
Practice Address - Country:US
Practice Address - Phone:410-820-7778
Practice Address - Fax:410-820-8862
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHORE HEALTH SYSTEM INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-19
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology