Healthcare Provider Details

I. General information

NPI: 1235242082
Provider Name (Legal Business Name): PLANNED PARENTHOOD OF MARYLAND, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 04/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 N HOWARD ST
BALTIMORE MD
21201-3610
US

IV. Provider business mailing address

330 N HOWARD STREET
BALTIMORE MD
21201
US

V. Phone/Fax

Practice location:
  • Phone: 410-576-1400
  • Fax: 410-576-7600
Mailing address:
  • Phone: 410-576-1400
  • Fax: 410-779-7910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State

VIII. Authorized Official

Name: JENNY BLACK
Title or Position: PRESIDENT/CEO
Credential:
Phone: 410-576-2176