Healthcare Provider Details

I. General information

NPI: 1376465849
Provider Name (Legal Business Name): GREATER BALTIMORE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6569 N CHARLES ST STE 301
BALTIMORE MD
21204-5815
US

IV. Provider business mailing address

6701 N CHARLES ST
BALTIMORE MD
21204-6808
US

V. Phone/Fax

Practice location:
  • Phone: 443-849-6622
  • Fax: 443-849-6828
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA CAMPBELL
Title or Position: SENIOR VP FINANCE
Credential:
Phone: 443-849-3844