Healthcare Provider Details

I. General information

NPI: 1205282464
Provider Name (Legal Business Name): FRANCIS SCOTT KEY MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2016
Last Update Date: 06/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4940 EASTERN AVE BLDG 01-0154
BALTIMORE MD
21224-2735
US

IV. Provider business mailing address

4940 EASTERN AVE BLDG 01-0154
BALTIMORE MD
21224-2735
US

V. Phone/Fax

Practice location:
  • Phone: 410-550-0961
  • Fax: 410-550-5566
Mailing address:
  • Phone: 410-550-0961
  • Fax: 410-550-5566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberP02057
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CARL FRANCIOLI
Title or Position: CFO, JHBMC
Credential:
Phone: 410-288-8022