MEDICARE: JOHNS HOPKINS EMERGENCY MEDICAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0002X	Emergency Care Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CH7643	OTHER	MD	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	F754	OTHER	MD	BCBS FEDERAL
4	LV01	OTHER	MD	BCBS

General Provider Information

NPI Number	:	1922098466
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHNS HOPKINS EMERGENCY MEDICAL

Provider Business Mailing Address
First Line	:	PO BOX 418937
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02241-8937
Country	:	US
Telephone Number	:	240-529-1456
Fax Number	:	301-631-5589

Provider Business Practice Location Address
First Line	:	5755 CEDAR LN
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-2912
Country	:	US
Telephone Number	:	240-529-1456
Fax Number	:

Authorized Official
Title or Position	:	SUPERVISOR
Name	:	MISS CHANTELL MARIE HAINES
Credential	:
Telephone Number	:	240-529-1456

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	10/22/2013

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