WESTERN MARYLAND HEALTH CARE CORPORATION NPI 1053727065

NPI Information

NPI: 1053727065
Provider Name: WESTERN MARYLAND HEALTH CARE CORPORATION

Doing Business As: MOUNTAIN LAUREL MEDICAL CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
104 PARKVIEW DR
GRANTSVILLE, MD
ZIP 21536
Phone: (301) 895-5107
Get Directions

WESTERN MARYLAND HEALTH CARE CORPORATION is a federally qualified health center (fqhc) clinic center in Grantsville, MD. WESTERN MARYLAND HEALTH CARE CORPORATION NPI is 1053727065. The provider is registered as an organization entity type.
The provider Is Doing Business As Mountain Laurel Medical Center.

The provider's business location address is:

104 PARKVIEW DR
GRANTSVILLE, MD
ZIP 21536-086
Phone: (301) 895-5107
Fax: (301) 533-3299

The provider's authorized official is Brian G Bailey .
The authorized official title is Ceo and has the following contact phone number (301) 533-3300.

The CLIA number assigned to this NPI record is 21D2165805 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/10/2014 and was last updated on 10/30/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7118	OTHER	MARYLAND	CAREFIRST BC/BS
2	410467600	MEDICAID	MARYLAND
3	103007026001	MEDICAID	PENNSYLVANIA
4	3810007182	MEDICAID	WEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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